血浆D-二聚体在急性主动脉夹层诊断中的价值

目的探讨血浆D-二聚体在急性主动脉夹层诊断中的价值。方法回顾分析2005年1月至2011年10月在我院确诊的69例急性主动脉夹层患者（简称主动脉夹层组）、同期70例急性肺栓塞患者（肺栓塞组）和70例因胸痛住院的其他患者（胸痛组）的血浆D-二聚体等临床资料，比较D-二聚体在不同类型患者中的水平差异，分析D-二聚体水平与急性主动脉夹层预后的关系。结果所有急性主动脉夹层患者D-二聚体均超过500μg／L，敏感性100％；死亡患者血浆D-二聚体浓度高于存活患者（P〈0．05）。血浆D-二聚体浓度主动脉夹层组、肺栓塞组和胸痛组分别为（3479．2±2200．0）μg／L、（1560．7±940．0）μg／L和（179．8±167．0）txg／L，三组比较P〈0．01，每两组比较P〈0．05。结论急性主动脉夹层患者血浆D-二聚体明显升高，其平均浓度超过急性肺栓塞患者。D-二聚体阴性有助于排除急性主动脉夹层的诊断；D二聚体升高对判断预后有-定的指导价值。

Value of plasma D-dimers for detection of acute aortic dissection

Objective To assess the value of plasma D-dimers in the detection of acute aortic dissection （AAD）. Methods With retrospective analysis,69 AAD patients from January 2005 to October 2011 were compared with 70 acute pulmonary embolism （APE） patients and 70 chest pain （CP） patients in the same period in the People＇s Hospital of Liaoning Province in order to find the difference of D-Dimers and other clinical data to confirm the relationship of D-dimer and AAD morality. Results Plasma D-dimer values in all AAD patients were over 500 μg/L with the sensitivity of 100%. Plasma D-dimer values of died patients were significantly higher than that of the survivals, Plasma D-dimer values of AAD patients were higher than those of APE patients and CP patients （3479.2±2200.0）μg/L vs （1560.7±940.0）μg/L vs （179.8±167.0）μg/L]. Conclusion Plasma D-dimers rose significantly in AAD patients. The mean of D-dimer of AAD patients is higher than that of APE patients. A negative D-dimer test result could be useful in excluding acute aortic dissection. The rise of D-dimer is helpful to evaluate the prognosis of AAD.