肺炎旁胸腔积液患者血浆纤维蛋白原和D-二聚体的变化及意义

目的 了解肺炎旁胸腔积液患者血浆纤维蛋白原(FBG)和D-二聚体(DD)的变化特征及其与病情的关系,为其治疗提供依据.方法 测定33例肺炎旁胸腔积液患者血浆FBG和DD,并与30名健康对照者、35例单纯社区获得性肺炎患者和21例肺栓塞患者比较,11例患者于治疗后重复测定.结果 肺炎旁胸腔积液患者FBG较健康对照组、单纯社区获得性肺炎组及肺栓塞组升高(P值均<0.05),DD较健康对照组和单纯社区获得性肺炎组升高(P值均<0.05),与肺栓塞组比较差异无统计学意义.复杂肺炎旁胸腔积液组FBG、DD较非复杂组升高(P值均<0.05).FBG和DD于治疗后降低(P值均<0.05).结论 肺炎旁胸腔积液患者DD和FBG明显升高,并与疾病严重度相关,提示存在凝血和纤溶的紊乱,DD和FBG的变化可以作为评价疾病严重度和治疗效果的指标.

Plasma levels of fibrinogen and D-dimer in patients with parapneumonic pleural effusion and their clinical significance

Objective To study the plasma levels of fibrinogen (FBG) and D-dimer (DD) in patients with parapneumonic pleural effusion and the relationship with the disease,and provide a basis for treatment. Methods The plasma FBG and DD of 33 patients with parapneumonic pleural effusion were measured,and compared with those of 30 healthy controls, 35 patients with pneumonia and 21 patients with pulmonary embolism. Those of 11 patients were repeatedly measured after treatment. Results The level of FBG in patients with parapneumonic pleural effusion was higher than that in control, pneumonia patients and pulmonary embolism patients. The level of DD in patients with parapneumonic pleural effusion was higher than that in control and pneumonia patients, but there was no statistical significance between patients with parapneumonic pleural effusion and patients with pulmonary embolism. The levels of FBG and DD in complicated parapneumonic pleural effusion group were higher than those in uncomplicated parapneumonic pleural effusion group. The levels of FBG and DD decreased after therapy. Conclusions The levels of DD and FBG increase significantly in patients with parapneumonic pleural effusion,and they are relative with the severity of the disease. It is suggested that there is disorder between coagulation and fibrinolysis,and the alternation of DD and FBG may be a useful index for evaluating the severity of the disease and therapeutic efficacy.