D-二聚体测定在血栓性疾病诊疗中的临床应用

目的探讨D-二聚体测定在血栓性疾病诊断及溶栓治疗疗效观察中的意义。方法采用ELISA法分别定量检测170名健康体检者、156例急性脑梗死、38例深静脉血栓和148例急性心肌梗死患者治疗前后的血浆D-二聚体含量。结果治疗前急性脑梗死、深静脉血栓、急性心肌梗死患者的血浆D-二聚体含量阳性率分别为59．3％、100．0％、61．7％,均高于健康对照组（4．3％）,差异均有统计学意义（均P〈0．01）。溶栓治疗后各组治疗有效患者的血浆D-二聚体含量在短时间内下降,与治疗前相比,差异有统计学意义（均P〈0．01）。结论血栓性疾病多伴有血浆D-二聚体含量增高,其测定有助于血栓性疾病的早期诊断。血浆D-二聚体检测对反映血栓性疾病溶栓疗效有一定意义,可作为观察溶栓药物用量的一个指标。

Clinical value of D-dimer in diagnosis and treatment of thrombotic diseases

OBJECTIVE: To investigate the clinical significance of D-dimer detection in the diagnosis and treatment of thrombotic diseases. METHODS: Peripheral blood samples were collected from 156 patients with acute cerebral infarction (ACI), 38 patients with deep venous thrombosis (DVT), and 148 patients with acute myocardial infarction (AMI), all under relevant treatment, and 170 healthy examinees. The level of plasma D-dimer was detected by ELISA before and after the treatment. RESULTS: The positive rates of plasma D-dimer of the ACI, DVT, and AMI patients before treatment were 59.3%, 100.0%, and 61.7% respectively, all significantly higher than that of the health examinees (4.3%, all P < 0.01). And the positive rates of plasma D-dimer decreased rapidly after treatment in the patients of these 3 groups who responded magnificently to thrombolysis treatment (all P < 0.01). CONCLUSION: Increased in most thrombotic patients, the plasma D-dimer level helps diagnose thrombotic diseases early and reflect the efficacy of thrombolysis treatment.