D―二聚体与缺血修饰白蛋白联合检测在心力衰竭中应用价值.docVIP

D―二聚体与缺血修饰白蛋白联合检测在心力衰竭中应用价值 　　【摘要】 目的 探讨联合检测D-二聚体与缺血修饰白蛋白（IMA）诊断心力衰竭的临床价值。 　　方法 42例心力衰竭患者作为心力衰竭组（心功能Ⅱ级19例、Ⅲ级16例、Ⅳ级7例）， 42例进行体检的健康人作为健康组， 检测两组D-二聚体、IMA及B型脑钠肽（BNP）水平， 并进行比较；同时常规治疗心力衰竭患者， 并检测不同心功能患者治疗后D-二聚体、IMA、BNP水平。结果 心力衰竭组D-二聚体、BNP、IMA水平分别为（1.31±0.24）μg/ml、（941.8±144.2）pg/ml、（91.5±12.5）U/ml， 均高于健康组的（0.20±0.06）μg/ml、（127.6±41.8）pg/ml、（67.2±10.7）U/ml， 差异均具有统计学意义（P0.05）。治疗后心功能Ⅳ级患者D-二聚体、BNP、IMA水平均高于心功能Ⅱ级与心功能Ⅲ级患者， 差异均具有统计学意义（P0.05）；治疗后心功能Ⅲ级患者D-二聚体、BNP、IMA水平均高于心功能Ⅱ级患者， 差异均具有统计学意义（P0.05）。结论 联合检测D-二聚体与IMA可有效诊断心力衰竭， 并对治疗后效果予以评估， 心功能越差者治疗效果越差， 值得推广。 　　【关键词】 D-二聚体；缺血修饰白蛋白；心力衰竭；B型脑钠肽 　　DOI：10.14163/j.cnki.11-5547/r.2018.10.005 　　【Abstract】 Objective To discuss the clinical value of D-dimer and ischemia modified albumin （IMA） for combined detection of heart failure. Methods There were 42 heart failure patients as heart failure group （19 cardiac function grade Ⅱ cases， 16 grade Ⅲ cases and 7 grade Ⅳ cases）， and 42 healthy people as healthy group. The D-dimer， IMA and B-type natriuretic peptide （BNP） level in two groups was detected and compared. The patients with heart failure were received routine treatment， and the levels of D-dimer， IMA， BNP after the treatment of patients with different grades of heart function were detected. Results Heart failure group had D-dimer， BNP and IMA level respectively as （1.31±0.24） μg/ml， （941.8±144.2） pg/ml and （91.5±12.5） U/ml， 　　which were all higher than （0.20±0.06） μg/ml， （127.6±41.8） pg/ml and （67.2±10.7） U/ml in healthy group， and their difference was statistically significant （P0.05）. After treatment， cardiac function grade Ⅳ patients had higher D-dimer， BNP and IMA level than grade Ⅱ and Ⅲ patients， and their difference was statistically significant （P0.05）. After treatment， cardiac function grade Ⅲ patients had higher D-dimer， BNP and IMA level than grade Ⅱ patients， and the difference was statistically significant （P0.05）. Conclusion Combined detection of D-dimer and IMA can effectively diagnose heart failure. The effect of trea