外伤性颅内血肿急性期血浆D-二聚体检测的临床价值

目的探讨外伤性颅内血肿急性期血浆D-二聚体(D-dimer)水平的动态变化与外伤性颅内血肿部位,治疗后转归的关系。方法采用透射免疫比浊法检测72例外伤性颅内血肿患者血浆D-dimer含量,并与62例高血压性脑出血患者和40例正常对照进行比较。结果外伤性颅内血肿患者血浆D-dimer致病后6 h、1周及2周血浆D-dimer水平显著升高,与高血压性脑出血患者组和正常对照组比较有显著牲差异(P<0.01),并以致病后6 h为最。同时,转归不良组血浆D-dimer水平显著升高,与转归良组比较有显著性差异(P<0.01)。结论外伤性颅内血肿急性期血浆D-dimer水平显著升高,揭示可能在该病急性期存在短暂的、纤溶活性增强的趋势。检测血浆D-dimer动态水平有助于判断抗纤溶治疗的效果及预测病情变化,并且血浆D-dimer水平的高低与出血部位、病人的转归密切相关。

Clinical Value of D.dimer in Plasma in Acute Phase of Traumatic Intracranial Hematoma

Objective To investigate the dynamic changes of plasma D. dimer leves of the patients with acute phase of traumatic intracranial hematoma and the part of inner haematoma, the relation of therapeutic outcomes. Methods To detect the plasma D. dimer levels of the 72 patients with traumatic intracranial hematoma by transmission imunoturbidimetry, compare with 50 hyperensive cerebral hemorhage and 40 healthy persons. Results The levels of D. dimer in plasma of the patients with traumatic intracranial hematoma were higher after suferes 6 hour, 1 week and 2 weeks than those of the patients with hypertensive cerebral hemorhage and in controls （ P 〈 0.01 ）. and the levels of D. dimer of the patients with traumatic intracranial hematoma after suferes 6 h were the most highest among them. The groups of bad outcome had singificantly higher levels of D. dimer than those of good outcome （ P 〈 0.01 ）. The patients of bad outcome were almost suferes that haematomate crashed through cerebral ventricle or subarachnoid cavity. Conclusion The plasma D. dimer levels of the patients with traumatic intracranial hematoma were significantly high, which hint the possibility that the activation of fibrinolysis mihgt incline to increase in forepart. The plasma D. dimer levels of the patients with traumatic intracranial hematoma should closely correlate with the position of hemorhage and therapeutic outcomes.