系统性红斑狼疮患者D-二聚体水平的检测及临床意义

目的测定系统性红斑狼疮（SLE）患者外周血中D-二聚体水平及其在SLE中的临床意义。方法采用免疫比浊法测定50例正常人、104例SLE患者和56例其他弥漫性结缔组织病（CTD）患者外周血中D-二聚体水平，并分析其与SLE患者的临床和实验室指标间的关系。结果正常人组、CTD组和SLE组间外周血中D-二聚体水平差异有统计学意义（F=7．893，P〈0．01）。将所有SLE患者分为D-二聚体水平升高组和D-二聚体水平正常组，与D-二聚体水平正常组相比，D-二聚体水平升高组SLEDAI积分、IgG水平、GLO水平、胸膜炎和心包炎发生率明显升高（P〈0．05），HB、C，、ALB水平明显降低（P〈0．05）。继发抗磷脂综合征的SLE患者外周血中D-二聚体水平明显高于无继发抗磷脂综合征的SLE患者（t=2．757，P=0．013）。SLE患者中抗Sm或抗C，q阳性组D-二聚体水平明显高于抗Sm或抗C1q阴性组（P〈0．05）。结论SLE患者外周血中D-二聚体水平明显升高，其升高与疾病活动性、继发抗磷脂综合征等反映SLE病情的指标相关。

The levels of plasma D - dimer and its clinical significance in patients with systemic lupus erythematosus

Objective To study the clinical significance of plasma D -dimer in patients with systemic lupus ery- thematosus （SLE）. Methods The levels of plasma D - dimer in 104 SLE patients, 56 other diffuse connective tissue disease patients （CTD） and 50 normal individuals were measured by immunoturbidimetry. Results The levels of D -dimer among SLE patients, CTD patients and normal individuals were significant different（ F = 7. 893, P 〈 0.01 ）. According to levels of plasma D -dimer, all the SLE patients were divided into two subgroups： subgroup 1 with rised level of D- dimer and subgroup 2 with normal level of D - dimer. The SLE disease activity inder, levels of immunoglubulin G and glubulin, incidence of pleurisy and pericarditis in subgroup 1 were higher than that in subgroup 2 （ P 〈 0.05 ）. The levels of hemoglobin, complement 3 and albumin in sub- group 1 were lower than that in subgroup 2（ P 〈0.05 ）. The levels of plasma D - dimer in SEE who were accompanied with antiphospholipid syndrome were obvious higher than that in SLE who were not accompanied with antiphospholipid syndrome （ t = 2. 757, P = 0. 013 ）. The levels of plasma D- dimer in SLE whose anti -Sm or anti -complement 1 q were positive were significant higher than that in SLE whose anti -Sm or anti -complement l q were negative（ P 〈 0.05 ）. Conclusions The levels of plasma D -dimer in patients with SLE rised obviously. Its rise associated with disease aetivity, antiphospholipid syndrome and other factors which could reflect the disease state of SLE.