标题：D-二聚体评价主动脉夹层不同类型及预后的临床研究

      作者：陈 倩，刘景峰，陈 锋，胡卫民，刘盛辉
    （北京市良乡医院急诊科，北京 102401）

      卷次： 2013年24卷4期

      【摘要】 目的 探讨血浆D-二聚体（DD）浓度与不同类型主动脉夹层(AD)在诊断、预后等方面的相关
性。方法 选取我院2008年1月至2011年12月经动脉三维血管成像（CTA）检查确诊为AD的患者35例；将其
分为Stanford A型（A组，16例）和Stanford B型（B组，19例）两组。检测两组患者血浆DD水平并统计学分析。
结果 （1）35例患者有 27例 DD＞0.5 μg/ml，诊断敏感性为 77.14%。（2）血浆 DD浓度值 Stanford A型大于
Stanford B型[(2.31±1.25）?g/ml vs (1.23±0.89) ?g/ml，P＜0.05]。（3）24 h内死亡患者DD值高于生存患者[（3.19±
0.74）?g/ml vs (1.36±0.98) ?g/ml，P＜0.05]，A组死亡率高于B组死亡率（37.5% vs 10.5%，P＜0.05），A组死亡患者
DD水平高于B组死亡患者水平[（3.40±5.17）?g/ml vs(1.9±0.00) ?g/ml，P＜0.05）]。结论 Stanford A型血浆D-二
聚体浓度高于Stanford B型。血浆D-二聚体浓度升高提示主动脉夹层撕裂范围增大，预后不良。

      【关键词】 D-二聚体；主动脉夹层；分型；预后

      【中图分类号】 R572 【文献标识码】 A 【文章编号】 1003—6350（2013）04—0483—03


Clinical study on evaluation of different types and prognosis of aortic dissection by D-dimmer.
CHEN Qian, LIU
Jing-feng, CHEN feng, HU Wei-min, LIU Sheng-hui. Department of Emergency, Beijing Liangxiang Hospital, Beijing
102401, CHINA

【Abstract】 Objective To explore the relationship between blood plasma D-dimmer concentration and diagnosis
and prognosis of different types of acute aortic dissection (AD). Methods Thirty-five patients confirmed as AD by CTA
in our hospital from January 2008 to December 2011 were divided into Stanford A type (group A) and Stanford B type
(group B). The D-dimmer levels in blood plasma were detected and statistically analyzed. Results (1) Of the 35 patients,
27 had relatively higher D-dimmer levels (>0.5 μg/ml), with the diagnostic sensitivity of 77.14%. (2) The D-dimmer lev-
els of group A was significantly higher than those of group B [ (2.31±1.25) μg/ml vs (1.23±0.89) μg/ml, P<0.05]. (3) The D-dim-
mer levels were significantly higher in patients who died within 24 hours than those survived [(3.19±0.74) μg/ml vs (1.36 ±
0.98) μ g/ml, P<0.05]. The mortality rate of group A was significantly higher than that of group B
[37.5% vs 10.5%, P<0.05], and the D-dimmer levels of the dead patients in group A were significantly
higher than those of the dead patients in group B [(3.40 ± 5.17) μ g/ml vs (1.9 ± 0.00) μ g/ml, P<0.05).
Conclusion The blood plasma D-dimmer levels of Stanford A type are higher than those of Stanford B type. The
increase of D-dimmer levels indicates the aggravation of aortic dissection and bad prognosis.

      【Key words】 D-dimmer; Aortic dissection; Types; Prognosis