血浆D-二聚体水平对急性主动脉夹层的诊断价值探讨

目的探讨血浆D-二聚体水平对主动脉夹层早期诊断、病变程度预测和预后判断的价值。方法顾分析天津市第五中心医院2005-2-2008-8就诊的66例主动脉夹层（AAD）患者（男51例，女15例），与同期就诊的急性冠脉综合症（ACS）患者（78例，男66例，女12例）作为对照，比较两组间包括D二聚体、C反应蛋白、肌钙蛋白I水平在内的各项临床常用指标的差异，分析D-二聚体在不同类型患者中的临床意义及病死相关性。结果急性主动脉夹层形成后D-二聚体水平显著升高，且D-二聚体水平与病变范围呈正相关（r=0．412，P〈0．01），死亡患者D-二聚体水平显著高于存活患者（P=0．001）。结论D-二聚体是AAD患者的早期生物标志，D-二聚体的水平阴性有助于排除急性主动脉夹层的诊断，该检测指标对判断病变范围和预后有一定的指导价值。

Diagnostic value of D-Dimer levels in acute aortic dissection (AAD)

Objecive To explore the effect of the serum D-Dimer on the early diagnosis ,degree and prognosis of acute aortic dissection （AAD）.Methods With retrospective analysis,66 AAD patients from Feb 2005 to Aug 2008 in Tianjin the Fifth Center Hospital were compared with 78ACS patients in the same period in order to find the difference of D-Dimer and other clinical indices including CPR,TnI,to confirm the reLationship of D-Dimer in different AAD types and AM） morality.Results With reforming of acute aortic dissection, the level of D-dimer will be dramatically high,and the degree of the elevation was correlated to the scope of dissection （ r = 0.412, P 〈 0.01）. D - Dimer of died patients was significantly higher than that of the survivals（P = 0.001）. Conclusion D-Dimer had important predictive value in the diagnosis of AAD.A negative D-Dimer test result could be useful in excluding AAD. The elevateed level of D-dimer was helpful to evaluate the extent of the dissection and outcome.