D-二聚体水平在狼疮性肠炎诊断中的临床意义

目的 探讨D-二聚体水平在狼疮性肠炎患者诊断中的临床意义.方法 89例系统性红斑狼疮(SLE)患者分为狼疮性肠炎组(10例)及狼疮无胃肠道病变组(79例),同期132例体检健康人群作为正常对照组.采用免疫比浊法检测不同组别血浆D-二聚体水平.结果 与正常对照组比较,SLE患者D-二聚体水平明显升高(0.14 ±0.24) mg/L比(0.40±0.21) mg/L,P＜0.05]；狼疮性肠炎组D-二聚体水平为(0.81±0.45) mg/L,与正常对照组比较,差异有统计学意义(P＜0.05)；狼疮无胃肠道病变组D-二聚体水平为(0.19±0.20) mg/L,较正常对照组略有升高,但差异无统计学意义(P＞0.05)；狼疮无胃肠道病变组与狼疮性肠炎组D-二聚体水平比较,差异有统计学意义(P＜0.01).79例无胃肠道病变组患者中,D-二聚体值升高者比例为43.0％ (34/79),其中76.5％(26/34)集中于合并神经精神性狼疮、狼疮性肾炎、肺动脉高压、心功能不全等重要脏器损伤患者.结论 D-二聚体水平在SLE患者中升高,与是否存在胃肠道病变如狼疮性肠炎相关.

Clinical significance of D-dimer level in patients with lupus enteritis

Objective To investigate clinical significance of D-dimer level in patients with lupus enteritis. Methods Immunoturbidimetry assay was used to detect the D-dimer level of the systemic lupus erythematosus （SLE） patients who were at the early/active stage of the disease. The 89 SLE patients were classified into two groups： lupus enteritis group and non-gastrointestinal disease group. The 132 health people were as normal control group. Immunoturbidimetry assay was used to detect the D-dimer level of the SLE patients who were at the early/ active stage of the disease and control group and analyze the difference of D-dimer level between different groups. Results The mean value of D-dimer of 89 SLE patients was （0.40 ±0.21 ） mg/L, which significantly higher than that in the normal control group （0. 14 ±0. 24）mg/L] （P 〈0. 05） ; The mean value of D-dimer in lupus enteritis group was （0. 81 ± 0. 45 ）mg/L which was significantly higher than that in the normal control group （P 〈 0. 05 ）. Meanwhile, the mean value of non-gastrointestinal disease group was （0. 19 ± 0. 20） mg/L, which was higher than that in the normal control group, which had no statistical significance （ P 〉 0. 05） ; At the same time, the mean value of D-dimer from lupus enteritis group was higher than that from non-gastrointestinal disease group, which had statistical significance（P 〈 0.01 ）. Thirty-four cases （43.0%）had higher D-dimer value in 79 non-gastrointestinal disease patients, and 26 cases （76.5%） who had higher D-dimer value were vital organ involved such as neuropsychiatric lupus,lupus nephritis, pulmonary hypertension and cardia insufficiency. Conclusions The high D-dimer value is mainly in SLE patients who are sufferring from vital organ involved. The high D-dimer value is also related to gastrointestinal disease such as lupus enteritis.