摘要
目的探讨血浆D.二聚体(DD)、乳酸脱氢酶同工酶3(LDH3)、组织型纤溶酶原激活物(t.PA)在早期急性肺栓塞患者中的变化及其临床意义。方法选取46例早期急性肺栓塞患者(肺栓塞组)及同期门诊正常体检无异常者50例(对照组),急性肺栓塞患者按照病情分为低危18例,中危15例,高危13例,对其进行DD、LDH3及bPA检测。结果肺栓塞组DD、LDH3及t-PA分别为(2.95±0.73)mg/L、(421.42±63.29)u,L、(0.85±0.02)u几,对照组分别为(0.03±0.01)mg/L、(198.17±23.37)U/L、(0.59±0.02)u/L,肺栓塞组DD、LDH3及bPA明显高于对照组(P〈0.05)。低危患者DD、LDH3、t-PA分别为(1.49±0.04)mg/L、(315.47±38.24)u/L、(0.63±0.01)U,L,中危患者分别为(2.22±0.27)mg/L、(382.41±54.36)u/L、(0.79±0.02)u/L,高危患者分别为(3.38±0.98)mg/L、(583.93±117.21)u,L、(0.92±0.03)U/L,中、高危患者与低危患者比较差异有统计学意义(P〈0.05);高危患者LDH3、t-PA与中危患者比较差异有统计学意义(P〈0.05)。肺栓塞组治疗后DD、LDH3、t-PA分别为(1.03±0.11)mg/L、(223.24±25.04)u,L、(0.62±0.02)u/L,较治疗前明显下降(P〈0.05)。结论在早期急性肺栓塞患者中DD、LDH3及t-PA均明显升高,随着病情缓解会逐渐下降,联合检测有助于急性肺栓塞的早期诊断。
Objective To explore the change of plasma D-dimer (DD), lactate dehydrogenase isoenzyme 3 (LDH3), tissue plasminogen activator (t-PA) in the early stage of acute pulmonary embolism and their clinical significance. Methods Forty-six patients with acute pulmonary embolism of early stage (pulmonary embolism group) and 50 cases of normal person (control group) were enrolled in this study. The patients in pulmonary embolism group were divided into low-risk ( 18 patients ), middle-risk ( 15 patients) and higher-risk (13 patients). The levels of DD, LDH3 and t-PA were detected and compared. Results The levels of DD, LDH3 and t-PA in pulmonary embolism group were (2.95±0.73) mg/L, (421.42±63.29) U/L and (0.85 ±0.02) U/L, and significantly higher than those in control group [(0.03±0.01) mg/L, (198.17±23.37) U/L and (0.59±0.02) U/L ] (P 〈 0.05 ). The levels of DD, LDH3 and t-PA in low-risk patients [ ( 1.49 ±0.04) mg/L, (315.47± 38.24) U/L and (0.63±0.01 ) U/L] were significantly lower than those in middle-risk patients [(2.22±0.27) mg/L, (382.41±54.36) U/L and (0.79±0.02) U/L] and higher-risk patients [ (3.38±0.98 ) mg/L, (583.93±117.21 ) U/L and (0.92±0.03 ) U/L] (P 〈 0.05 ). The levels of LDH3 and t-PA in middle-risk patients were significantly lower than those in higher-risk patients (P 〈 0.05 ). After treatment, the levels of DD, LDH3 and t-PA were significantly decreased [ (2.95± 0.73 ) mg/L vs. (1.03±0.11) mg/L, (421.42 ±63.29) U/L vs. (223.24±25.04) U/L, (0.85 +0.02) U/L vs. (0.62±0.02) U/L](P〈0.05). Conclusions The levels ofDD, LDH3 and t-PA in the early stage of acute pulmonary embolism are increased significantly, and with the remission of the patient's condition, the levels of DD, LDH3 and t-PA are decreased. United detection conduces to the diagnosis of acute pulmonary embolism.
出处
《中国医师进修杂志》
2012年第34期34-36,共3页
Chinese Journal of Postgraduates of Medicine