| D-二聚体水平测定对结缔组织病相关肺动脉高压的诊断意义 |
| 投稿时间：2014-11-02 修订日期：2014-11-24 点此下载全文 |
| 引用本文：崔晓阳,冯春颜,朱彩云,张刘兵,周卫.D-二聚体水平测定对结缔组织病相关肺动脉高压的诊断意义[J].医学研究杂志,2015,44(6):148-150 |
| DOI：
10.11969/j.issn.1673-548X.2015.06.042 |
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| 中文摘要:目的 探讨外周血中D-二聚体水平的变化在结缔组织病相关肺动脉高压的临床诊断中的意义。方法 从465例结缔组织病(CTD)患者中筛选出伴有肺动脉高压(PAH)的患者95例,对其临床实验室检查特点及治疗转归进行回顾性分析,选取同时期未检出肺动脉高压的CTD患者65例为对照组,采用免疫比浊法测定两组患者的外周血中D-二聚体水平,并比较D-二聚体水平在结缔组织病患者肺动脉高压中的诊断价值。结果 结缔组织病合并的PAH的总发生率约为20.4%。其中系统性红斑狼疮合并肺动脉高压发生率最高,为42.1%,类风湿关节炎次之,为24.2%。CTD合并PAH患者外周血中D-二聚体水平明显高于对照组,差异有统计学意义(Z=-3.57,P<0.05)。其中系统性红斑狼疮、混合性结缔组织病、系统性硬化症及血管炎病继发PAH的患者D-二聚体的浓度显著高于未继发PAH患者(P<0.05),而在类风湿关节炎、炎性肌病、干燥综合征及未分化的结缔组织病患者中,差异无统计学意义(P>0.05)。结论 PAH与多种CTD密切相关,血清D-二聚体与结缔组织病患者并发PAH密切相关,但在不同种类CTD疾病患者中的临床诊断意义或存在差异。 |
| 中文关键词:D-二聚体 结缔组织病 肺动脉高压 |
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| Significance of Detecting the Level of Plasma D-dimer in Patients with Connective Tissue Disease-associated Pulmonary Arterial Hypertension |
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| Abstract:Objective To investigate the significance of plasma D-dimer in patients with connective tissue disease (CTD)-associated pulmonary arterial hypertension (PAH). Methods We selected 95 patients with pulmonary hypertension from 465 patients with connective tissue disease. Meanwhile, we selected 65 undetected pulmonary hypertension CTD patients as the control group, all cases with pulmonary arterial hypertension in CTD patients were analyzed retrospectively. The risk factor of PAH was evaluated and the prognostic influence of different treatments and primary diseases was analyze. The levels of plasma D-dimer were measured by immunoturbidimetry. In addition, we compared the diagnostic value of D-dimer levels in the connective tissue of patients with pulmonary hypertension. Results The overall incidence of PAH in connective tissue disease was about 20.4%. In these patients, systemic lupus erythematosus and rheumatoid arthritis had the highest incidence of PAH (42.1% and 24.2%). The levels of plasma D-dimer in CTD-PAH patients were significantly higher than the control group (Z=-3.57,P<0.05). In addition, the levels of plasma D-dimer in systemic lupus erythematosus, mixed connective tissue disease, and systemic sclerosis and vasculitis disease associated pulmonary hypertension were significantly higher in patients without PAH (P<0.05). However, in rheumatoid arthritis, inflammatory myopathies, sjogren's syndrome and undifferentiated connective tissue disease associated pulmonary hypertension, the difference was not statistically significant (P>0.05). Conclusion PAH is closely related to a variety of CTD. The rising levels of plasma D-dimer is associated with disease activity and secondary PAH in connective tissue disease, but it was different in the diagnostic value among different types of CTD diseases. |
| keywords:D-dimer Connective tissue disease Pulmonary arterial hypertension |
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