D-二聚体水平在系统性红斑狼疮的临床意义

目的 了解系统性红斑狼疮(SLE)患者D-二聚体水平及其临床意义.方法 选北京大学人民医院住院的261例SLE患者,收集临床及实验室资料,分析D-二聚体水平及其与SLE患者临床特征及实验室检查指标的相关性.结果 (1)除外合并肾功能不全、严重感染、弥漫性血管内凝血(DIC)、肝功能异常、妊娠及外伤等可能影响D-二聚体水平的因素,261例SLE患者中入选205例,其中D-二聚体水平升高者达69.3%(142/205).(2)D-二聚体水平升高与SLE疾病活动指数(SLEDAI)评分呈正相关(r=0.598,P=0.000),并与抗双链DNA抗体阳性、C反应蛋白(GRP)升高、补体C3、补体C4降低等有一定相关性.(3)D-二聚体水平升高者脏器损伤比例增加,狼疮性肾炎(58.5%比38.1%)、神经精神性狼疮的发生率(18.3%比4.8%)明显高于D-二聚体水平正常者.(4)伴有血栓形成的SLE患者均有D-二聚体水平升高,但不合并血栓形成者D-二聚体水平升高或正常.结论 D-二聚体水平升高可见于SLE活动期及有重要脏器损伤者,并不必然提示血栓形成.但是,伴发血栓形成的SLE患者均有D-二聚体升高.

The clinical significance of D-dimer in systemic lupus erythematosus

Objective To investigate the clinical significance of D-dimer in systemic lupus erythematosus (SLE). Methods The study group comprised 261 SLE patients who were admitted in ward from 2005 to 2008 in Peking University People's Hospital Collect the clinical data to investigate the clinical significance of D-dimer. Results ( 1 ) The D-dimer levels of 56 patients were increased due to coexist reduced renal function, infections, disseminated intravascular coagulation ( DIC), liver disorders, pregnancy and injury. With the exception of above patients, 142 ( 69. 3 ) patients were increased in total 205 patients. (2)The level of D-dimer was positively correlated with SLE disease activity index( SLEDAI ) score ( r =0. 598,P =0. 000), and was associated with anti-dsDNA antibody, ESR, C-reactive protein(CRP) and complement C3 and C4. (3)D-dimer level was associated with important organ involvement. (4)All patients with thrombosis had increased D-dimer, but patients without thrombosis had normal or increased D-dimer levels. Conclusion The level of D-dimer elevates in patients with active disease or important organ involvement , it can not identify thrombosis. All patients with thrombosis had increased D-dimer levels.