不同肺部疾病的老年患者血浆D-二聚体水平测定及临床意义.doc

不同肺部疾病的老年患者血浆D-二聚体水平测定及临床意义 目的：血浆D-二聚体(D-dimer，DD)是纤维蛋白单体经过活化因子交联后，再经过纤维溶解酶水解所产生的一种特异性降解产物，其水平的升高反映高凝状态和继发纤溶亢进，D的含量变化可以作为体内高凝状态和纤溶亢进的分子标志物之一。反映出的特异性并不是指在某一种特定的具体疾病中的表现Yuan-kaifen ;zhao-guohou;Yang-jianhua;Fan-mingjuan Cadre Department of the Second Hospital affiliated to KunMing Medical University, Kunming, 650101 [Abstract]　Objective: To investigate the clinical significance of the level of plasma D-dimer in elderly patients with different pulmonary diseases. Method: The plasma D-dimer level was measured in 310 patients with pneumonia, tuberculosis ,the exacerbation stage of Chronic obstruct pulmonary disease, acute pulmonary embolism ,primary lung cancer, ambulant lung cancer, and the results of D-dimer in six groups were compared.Result:The levels of D-dimer in 236 patients were apparently higher than those in control group(P0.05). The levels of D-dimer in patients with tuberculosis, the exacerbation stage of Chronic obstruct pulmonary disease, acute pulmonary embolism, primary lung cancer and ambulant lung cancer, were obviously higher than those in patients with pneumonia (P0.05).The levels of D-dimer were not significantly different in patients with tuberculosis, the exacerbation stage of Chronic obstruct pulmonary disease , primary lung cancer and ambulant lung cancer(P0.05). The levels of D-dimer in patients with acute pulmonary embolism were much higher than that that in tuberculosis, the exacerbation stage of Chronic obstruct pulmonary disease, primary lung cancer and ambulant lung cancer(P0.05).Conclusion: Different pulmonary diseases(pneumonia, tuberculosis , the exacerbation stage of Chronic obstruct pulmonary disease, acute pulmonary embolism,primary lung cancer and ambulant lung cancer) may be related to the abnormal blood coagulation state. The diagnosis of acute pulmonary embolism in patients with normal level of D-dimer may be ruled out, but we can not use it as the index of the severity degree of the pulmonary disease. [Key words]　D-dimer; Pulmon