深静脉血栓患者血浆中溶血磷脂酸与 D-二聚体的变化和意义

目的 探讨不同发病阶段（急性期、亚急性期、慢性期）的深静脉血栓形成（DVT）患者血浆中溶血磷脂酸（LPA）和D-二聚体水平变化的临床意义。方法 选取2013年4～11月在山西大医院血管外科住院的DVT患者34例，其中急性期（病程≤14d）的患者14例（急性组），亚急性期（病程15～28d）的患者10例（亚急性组），慢性期（病程≥28d）的患者10例（慢性组）；同时选取8例健康体检者为对照组。分别测定各组经相同抗凝活血等治疗前及治疗后第3天、第7天、第14天的血浆LPA及D-二聚体。结果 急性组、亚急性组、慢性组治疗前及治疗后第3天、第7天、第14天的血浆LPA水平均高于对照组，差异有高度统计学意义（P〈0．01）。急性组、亚急性组、慢性组治疗前及治疗后第3天、第14天的血浆D-二聚体水平均高于对照组，差异有高度统计学意义（P〈0．01）。急性组、亚急性组及慢性组LPA值和D-二聚体值随着治疗时间呈下降趋势。结论 血浆LPA、D-二聚体作为体内凝血和血栓形成早期的分子标志物，有重要临床诊断价值。

Dynamic changes and significance of lysophosphatidic acid and D-dimer in patients with deep venous thrombosis

Objective To explore the changes and clinical significance of lysophosphatidic acid （LPA） and D-dimer in patients with deep venous thrombosis （DVT）. Methods 34 cases of patients with DVT from April to November 2013 in Department of Vascular Surgery, Dayi Hospital of Shanxi Medical University were selected, and they were divided into 3 groups： 14 cases of acute phase （course of ≤ 14 d, acute group）, 8 cases of subacute phase （course of 15-28 d, subacute group）, 10 cases of chronic phase （course of ≥ 28 d, chronic group）, at the same time, 8 healthy persons were selected as control group. Before and after same anticoagulant blood treatment 3 days, 7 days, 14 days, the levels of LPA and D-dimer of each group were determined. Results The levels of LPA in acute group, subacute group and chronic group before 1 days and after treatment 3 days, 7 days, 14 days were higher than that in control group, the differences were statistically significant （P 〈 0.01）. The levels of D-dimer in acute group, subacute group and chronic group before 1 days and after treatment 3 days,and 14 days were higher than that in control group, the differences were statistically significant （P 〈 0.01）. The levels of LPA and D-dimer showed the declining trend following with the treatment. Conclusion LPA and D-dimer show importance as the marker in the earlier period of thrombosis.