外伤性颅内血肿急性期血浆D-二聚体检测的价值
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摘要
目的探讨外伤性颅内血肿急性期检测D-二聚体的临床价值。方法方便选取2013年6月—2016年6月该院收治的90例外伤性颅内血肿患者为实验组,另择取同期90名健康志愿者为对照组,两组分别于入院初和健康体检时采血,常规检测血浆D-二聚体水平。对比观察对照组与实验组不同程度脑损伤患者D-二聚体水平间的差异性,观察实验组不同预后结果患者的D-二聚体水平变化。结果实验组血浆D二聚体(297.1±38.5)μg/L,对照组血浆D二聚体(113.7±21.4)μg/L,比较差异有统计学意义(P<0.05);颅脑损伤重型组D-二聚体(446.1±58.9)μg/L,显著高于轻型组和中型组(P<0.05);颅脑损伤术后恢复良好者D-二聚体(230.7±16.3)μg/L,显著低于轻残、重残及死亡的患者(P<0.05)。结论外伤性颅脑损伤严重程度及预后与患者血浆D-二聚体水平存在关联,急性期D-二聚体水平升高可能提示纤溶活性增强,临床应注重加强动态观察。
Objective To discuss the value of test of plasma D-dimer of traumatic intracranial hematoma during the acute period. Methods 90 cases of patients with traumatic intracranial hematoma in our hospital from June 2013 to June 2016 were convenient selected as the experimental group, and 90 cases of healthy volunteers at the same period were selected as the control group, and the blood of both groups was collected at the beginning of admission and at healthy physical examination, and the difference in the D-dimer of traumatic intracranial hematoma was compared between patients of different cerebral injuries, and the different prognosis results in the experimental group was observed and the changes of plasma Ddimer of patients were observed. Results The difference in the plasma D-dimer between the experimental group and the control group was statistically significant[(297.1±38.5)μg/L vs(113.7±21.4)μg/L](P<0.05), and the plasma D-dimer in the severe group was obviously higher than that in the mild group and the moderate group(446.1±58.9)μg/L(P<0.05), and the Ddimer of cerebral injury patients with good recovery after operation was(230.7±16.3)μg/L, which was obviously lower than that of disabled patients, severe disabled patients and death patients(P<0.05. Conclusion The severity and prognosis of patients with traumatic intracranial hematoma have a correlation with the plasma D-dimer level, and the increase of plasma D-dimer during the acute period may remind the enhancement of fibrinolysin activity, and we should pay attention to enhance the dynamic observation in clinic.
Objective To discuss the value of test of plasma D-dimer of traumatic intracranial hematoma during the acute period. Methods 90 cases of patients with traumatic intracranial hematoma in our hospital from June 2013 to June 2016 were convenient selected as the experimental group, and 90 cases of healthy volunteers at the same period were selected as the control group, and the blood of both groups was collected at the beginning of admission and at healthy physical examination, and the difference in the D-dimer of traumatic intracranial hematoma was compared between patients of different cerebral injuries, and the different prognosis results in the experimental group was observed and the changes of plasma Ddimer of patients were observed. Results The difference in the plasma D-dimer between the experimental group and the control group was statistically significant[(297.1±38.5)μg/L vs(113.7±21.4)μg/L](P<0.05), and the plasma D-dimer in the severe group was obviously higher than that in the mild group and the moderate group(446.1±58.9)μg/L(P<0.05), and the Ddimer of cerebral injury patients with good recovery after operation was(230.7±16.3)μg/L, which was obviously lower than that of disabled patients, severe disabled patients and death patients(P<0.05. Conclusion The severity and prognosis of patients with traumatic intracranial hematoma have a correlation with the plasma D-dimer level, and the increase of plasma D-dimer during the acute period may remind the enhancement of fibrinolysin activity, and we should pay attention to enhance the dynamic observation in clinic.
引文
[1]张均迈.急性颅脑外伤后凝血功能及D-二聚体变化临床观察[J].中国实用神经疾病杂志,2014,17(3):46-47.
[2]王笃前,于守永,徐勇,等.D-二聚体及超敏C反应蛋白对创伤后颅内进展性出血性损伤的诊断价值[J].临床神经外科杂志,2013,10(2):110-112.
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[5]李晓兴,马建华,季海明,等.颅脑外伤后凝血及抗凝因素与其预后的临床研究[J].医学研究杂志,2012,41(6):127-129.
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[8]吕秀程.脑外伤患者血浆D-D、C-反应蛋白和纤维蛋白原的检测及临床观察[J].中国现代药物应用,2013,7(20):78-79.
[2]王笃前,于守永,徐勇,等.D-二聚体及超敏C反应蛋白对创伤后颅内进展性出血性损伤的诊断价值[J].临床神经外科杂志,2013,10(2):110-112.
[3]张洪祥,马毅军,吕旭东,等.血浆D-二聚体浓度与脑外伤预后的相关分析[J].放射免疫学杂志,2012,25(5):560-562.
[4]赵志强,杨飞云.D-二聚体在儿童颅脑创伤后的变化及意义[J].中国现代医学杂志,2012,22(4):57-60.
[5]李晓兴,马建华,季海明,等.颅脑外伤后凝血及抗凝因素与其预后的临床研究[J].医学研究杂志,2012,41(6):127-129.
[6]王晓锋,李海永,王生虎,等.脑外伤患者血浆D-D、CRP和Fb的检测及临床观察[J].放射免疫学杂志,2012,25(3):310-311.
[7]邓引生,焦磊,吴旻,等.D-二聚体和C反应蛋白在脑外伤后的表达变化及临床意义[J].江苏医药,2013,39(16):1906-1908.
[8]吕秀程.脑外伤患者血浆D-D、C-反应蛋白和纤维蛋白原的检测及临床观察[J].中国现代药物应用,2013,7(20):78-79.