摘要
目的探讨D-二聚体与超敏C反应蛋白（hs-CRP）在急性主动脉夹层（AAD）早期诊断中的意义及对预后判断的价值。方法选取2014年3月至2015年3月期间兰州军区总医院收治的70例AAD病例,记录分别在发病〈6 h、6~12 h、1 d、3 d、手术中、术后1 d、术后2 d及术后7 d时的D-二聚体和hs-CRP水平,并分析两者在AAD早期诊断中监测的意义及对预后判断的作用。结果 De Bakey I型AAD患者的hs-CRP、D-二聚体水平均显著高于De BakeyⅡ型和De BakeyⅢ型[hs-CRP：（109.34±46.81）mg/L vs（75.63±39.84）mg/L vs（69.55±35.27）mg/L,D-二聚体：（2.82±0.89）mg/L vs（1.19±0.48）mg/L vs（0.77±0.26）mg/L],差异有统计学意义（P〈0.05）;De BakeyⅡ型与De BakeyⅢ型之间的CRP及D-二聚体浓度比较差异无统计学意义（P〉0.05）。发病后D-二聚体及hs-CRP水平均明显上升,hs-CRP在发病12 h后开始上升,D-二聚体在12 h内开始上升,两者均在术后3 d达到高峰,术后7 d明显降低;D-二聚体和hs-CRP水平无并发症组患者显著低于并发症组（P〈0.05）,非死亡组显著低于死亡组（P〈0.05）。结论 hs-CRP和D-二聚体水平监测有利于AAD早期的鉴别诊断,与AAD患者的生存时间相关。
Objective To discuss the monitoring and prognosis significance of D-dimer and high-sensitivity C-reactive protein （hs-CRP） for acute aortic dissection. Method 70 cases of acute aortic dissection treated in General Hospital of Lanzhou Military Area Command from March 2014 to March 2015 were chosen for the study. D-dimer and hs-CRP levels were measured at 〈6 h, 6-12 h, 1 d, and 3 d after occurrence of the disease, and at 1 d, 2 d, and 7 d after operation. The monitoring and prognosis significance for the disease were analyzed. Results The CRP and D-dimer levels （109.34±46.81）rag/L, （2.82± 0.89）mg/L of De Bakey type I AAD patients were significantly higher than those of de Bakey type II （75.63±39.84 rag/L, （1.19±0.48） mg/L and de Bakey type II （69.55±35.27） mg/L, （0.77±0.26）mg/L, but there were no significant differences between de Bakey type II and de Bakey type III （P〉0.05）. After onset, the levels of D-dimer and high sensitive C reactive protein were significantly increased, started raising from 12 h after onset and reached a peak at the 3 d after operation, and then obviously decreased at the 7 d after the surgery; the D-dimer and high sensitivity C reactive protein levels of no complications patients were significantly lower than those of the complication group （P〈0.05）, and the D-dimer and hs-CRP levels of non death group were significantly lower than those of death group （P〈0.05）. Conclusion Hs-CRP and D-dimer levels of monitoring favor early differential diagnosis of acute aortic dissection, and is closely related to survival time of acute aortic dissection patients.
出处
《热带医学杂志》
CAS
2016年第1期63-65,81,共4页
Journal of Tropical Medicine
