慢性心力衰竭患者血浆D-二聚体与LVEF检测及意义

[目的]通过定量检测慢性心力衰竭患者血浆D-二聚体水平,探讨慢性心力衰竭与高凝状态的关系,为慢性心力衰竭抗凝治疗提供理论依据.[方法]应用散射免疫比浊法分别定量检测慢性心力衰竭患者（心功能Ⅱ～Ⅳ级）组（n=60）和健康对照组（n=30）血浆D-二聚体含量;应用彩色多普勒超声心动图测定慢性心力衰竭患者左心室射血分数（LVEF）;并对心衰患者组按心衰程度、LVEF不同进行分组,分别比较各亚组组间血浆D-二聚体水平,并对结果进行统计学分析.[结果]①慢性心力衰竭患者组血浆D-二聚体含量较健康对照组明显升高,两组比较有显著性差异（P〈0.01）;②随心衰程度加重,D-二聚体水平明显升高,不同心衰程度患者组间比较有显著性差异（P〈0.01）;③随LVEF值降低,D-二聚体水平无明显升高,各不同射血分数（EF）水平患者组间比较无显著性差异（P〉0.05）,两者无明显相关性（r=-0.215,P=0.098）.[结论]①慢性心力衰竭患者体内存在高凝状态;②随心衰程度加重,高凝状态更为严重;③慢性心力衰竭患者左心室射血分数与高凝状态无明显相关性.

Measurement of Plasma D-dimer in Patients with Chronic Heart Failure and Its Clinical Significance

[Objective] To explore the relationship between chronic heart failure（CHF） and hypereoagulable state by determination of plasma D-dimer and provide the therapeutic basis for anticoagulant therapy of CHF. [Methods] The concentration of plasma D-dimer was measured in CHF group（n=60）, and in the normal control group（n=30） . Eehocardiography was applied to detect left ventricular ejection fraction （LVEF）. Patients with CHF were divided into different subgroups according to New York Heart Association （NYHA） classification and their LVEF. The levels of plasma D-dimer among different subgroups were respectively compared. [Results] The concentration of plasma D-dimer in patients with CHF was remarkably higher than that in the normal control group（ P〈0.01）. The levels of plasma D-dimer increased while the grades of severity of CHF increased, and there was significant difference among the different groups （ P〈0. 01）. The level of plasma D-dimer increased with the decreasing of LVEF. There was no significant difference in LVEF among the different groups（ P〉0.05）. There was no correlation between plasma D-direct and LVEF（r=-0. 215, P = 0. 098）. [Conclusion] Hypercoagulation state is present in chronic heart failure. The more severe the stages of heart failure, the more severe hypercoagulation state. There is no correlation between LVEF and hypercoagulation state in patients with CHF.