冠心病患者血浆D-二聚体含量的变化及其临床意义

研究了96例冠心病(CHD)患者血浆纤维蛋白降解产物D-二聚体(D-dimer)含量的变化。对象包括急性心肌梗塞44例(AMI组),陈旧性心肌梗塞16例(OMI组),不稳定型心绞痛21例(UA组),稳定型心绞痛15例(SA组),健康中、老年人20例(对照组)。结果AMI、OMI、UA组的D-dimer含量较对照组有显著增高,其含量分别为(1.89±1.62)、(0.92±0.89)、(1.03±0.98)mg/L(均为P<0.01)。而SA组与对照组无显著差异(P<0.05)。认为冠心病患者血浆D-dimer的变化,可作为诊断继发性纤溶的较好的指标,以及CHD体内血栓前状态和溶栓治疗的指标。

The Changes of Plasma D-dimer Levels in Patients with Coronary Heart Disease and Its Clinical Significance

Plasma samples from 96 patients with coronary heart disease (CHD) were examined for fibrin degradation product- D- dimer. The subjects were divided into five groups: 44 cases of acute myocardial in-farction (AMI group), 16 cases of remote myocardial infarction (OMI group), 21 cases of unstable angina pectoris (UA group), 15 cases of stable angina pectoris (SA group) and 20 healthy aged persons as control group. The results showed that plasma D- dimer levels of in AMI group, OMI group and UA group were sig-nificantly higher than that of control group. The plasma concentrations of the three groups were (1, 89il. 62), (0. 92?. 89) and (1. 03?. 98) mg/L respectively. In contrast, there was no significant difference in plasma levels of D-dimer between SA group and control group. The results suggest that the changes of plas-ma D-dimer levels can be considered as a better diagnostic marker of secondary fibrinolysis and prethrombotic state in CHD patients. The marker can also be used to be a guiding index of thrombolysis in CHD patients.