心血管介入手术后D-二聚体的变化及其意义

探讨介入术后D-二聚体(DD)变化及其起对血栓性疾病的预测意义。892例行心血管介入诊疗的患者在术前、术后第1,2,3天定量测定DD,对DD高于正常值上限2倍以上(≥1000μg/L)者则在第7,14天再监测DD。结果:①患者术后3天DD较术前明显升高(496.32±28.15μg/Lvs310.28±26.87μg/L,P<0.01);②各组患者术后1,2,3天DD均较术前显著升高(P<0.01),术后1天的增幅最大,术后3天的增幅较小;③有128例患者DD显著升高(≥1000μg/L),其中8例为持续性升高,第7,14天分别为3526.38±1045.45μg/L和3376.75±1015.31μg/L,2例为冠状动脉支架内急性闭塞,5例为深静脉血栓形成,1例为肺栓塞。结论:心血管介入可导致患者血液中DD升高,多为一过性,持续性增高往往提示血栓性疾病的发生。

The Clinic Value of the Di-dimmer Changing in Patients Who Had Been Carried out Cardiovascular Intervention

To investigate the di-dimmer(DD) changing and it′s clinic value in predicting thrombosis disease after cardiovascular intervention, DD were tested before intervention, and after 1, 2, 3days in 892 patients who had been carried out cardiovascular intervention, and if DD was 2 times higher than that of the normal high limitation(≥1 000 μg/L),DD should be tested at 7 and 14 days after the intervention. Results: ①DD increased significantly at 3 days after the interve ntion (496.32± 28.15 μg/L vs 310.28±26.87 μg/L,P<0.01);②DD increased significantly a t 1,2,3 days after the intervention in all group (P<0.01),in addition,at 1 day,the increased amount was the biggest,and the smallest at 3 days;③One hund red and twenty-eight patients were found that DD increased significantly (≥1 000 μg/L), and in 8 cases of them, the DD kept hi gh level after two weeks, from which 2 cases were acute occlusion in coronary artery stent, 5 cases were deep venous t hrombosis, and 1 case was pulmonary embolism. Conclusions: Cardiovascular intervention can lead to the increase of DD in patient′s blood, but it is not persisting in most patients,and if it is holding high level ,the complications of thrombosis disease can be indicated .