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find Keyword "D-二聚体" 28 results
  • Correlation Between Plasma D-Dimer Level and Vascular Invasion as well as the Pittsburgh Modified TNM Staging in Patients with Hepatocellular Carcinoma for Orthotopic Liver Transplantation

    【Abstract】Objective To evaluate the prognostic value of plasma D-dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D-dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation. MethodsThe plasma D-dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D-dimer level in different Child-pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with χ2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.ResultsIn ChildPugh’s A, B and C patients, the difference of plasma D-dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant (P<0.05). The differences of plasma D-dimer level between patients with microvascular invasion and patients without vascular invasion were significant (P<0.01) in Child-Pugh’s B and C patients but was insignificant in Child-Pugh’s A patients (Pgt;0.05). The differences of plasma D-dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant (P<0.05), but the differences of plasma D-dimer level between patients with the Pittsburgh modified TNM Ⅲ tumor and patients with TNM Ⅳ tumor were insignificant (Pgt;0.05).ConclusionPlasma D-dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child-pugh’s classification.

    Release date:2016-08-28 04:30 Export PDF Favorites Scan
  • A Clinical Comparative Study on Intrapleural Heparin Versus Urokinase in the Management of Tuberculous Pleurisy

    Objective To compare the effects of heparin versus urokinase injection intrapleurally in the management of pleural thickening and adhesion due to tuberculous exudative pleurisy. Methods Sixty patients with tuberculous pleurisy were allocated into three groups randomly. Sodium heparin ( heparin group) , urokinase ( urokinase group) , and 0. 9% saline ( control group) were intrapleurally injected respectively. The concentrations of fibrinogen and D-dimer in pleural effusion were measured before and after the injection. The duration of absorption and the total drainage volume of pleural effusion were recorded. The pleural thickness and adhesion were observed two months after the injection. Results In 72 hours after the intrapleural injection, the concentration of fibrinogen( g/L) in the pleural effusion was significantly increased in the heparin group( 1. 13 ±0. 44 vs 0. 34 ±0. 19, P lt; 0. 001) , and significantly decreased in the urokinase group( 0. 25 ±0. 16 vs 0. 38 ±0. 15, P lt; 0. 05) when compared with baseline. Concentrations of D-dimer in the pleural effusions were significantly higher than those at baseline in both the heparin group and the urokinase group( 57. 0 ±17. 6 vs 40. 0 ±15. 4, P lt; 0. 05; 74. 5 ±16. 4 vs 43. 8 ±14. 9, P lt; 0. 001) . There were no significant differences in the absorption duration of pleural effusion among the three groups( P gt;0. 05) . The total drainage volume of pleural effusion was higher in the heparin group and the urokinase group compared to the control group( P lt;0. 01) . And the total volume of pleural effusion was significantly higher in the heparin group and the urokinase group than that in the control group( 2863 mL and 2465 mL vs 1828 mL,P lt;0. 01) . Two months after the intervention, the pleura were thinner[ ( 1. 37 ±0. 82) mm and ( 1. 33 ±0. 85) mmvs ( 3. 06 ±1. 20) mm, P lt; 0. 01] and the incidence of pleural adhesion was significantly lower[ 15% and 20% vs 50% , P lt; 0. 05] in the heparin and the urokinase groups than those in the control group.Conclusion Intrapleural heparin has similar effects with urokinase for prevention pleural thickness andadhesion in tuberculous pleurisy with good availability and safety.

    Release date:2016-09-14 11:23 Export PDF Favorites Scan
  • 前白蛋白、D-二聚体及血小板动态变化评估重症脓毒症患者病情严重度的临床分析

    目的 研究前白蛋白( PA) 、D-二聚体( DD) 及Plt 动态变化与重症脓毒症患者病情严重度及预后的关系。方法 测定198 例重症脓毒症患者入组第1 d、第5 d, 以及出院或死亡前最后一次的PA、DD、Plt、APACHEⅡ 评分, 按预后将患者分为死亡组及存活组, 进行动态观察, 并做APACHEⅡ评分和PA、DD 及PLT 水平动态变化的相关性分析。结果 死亡组与存活组入组第1 dPA、DD 及Plt 比较均无显著差异, 死亡组第5 d 及最后一次DD 水平明显高于存活组( P lt;0. 05) , PA和Plt 明显低于存活组( P lt;0. 01) 。DD 与APACHEⅡ评分呈正相关, PA、Plt 与APACHEⅡ评分呈负相关。结论 DD与脓毒症患者病情严重程度呈正相关, PA 与病情严重程度呈负相关。DD 持续高水平与PA、Plt 持续低水平提示病情危重, 预后不良, 所以联合动态观察PA、DD 和Plt 对判断病情危重度及预后有一定的评估价值。

    Release date:2016-09-14 11:23 Export PDF Favorites Scan
  • The Differential Diagnostic Value of Major Fibrinolytic Parameters in Pleural Fluid

    【Abstract】Objective To explore the differential diagnostic value of major fibrinolytic parameters in pleural fluid. Methods Tissue-type plasminogen activator( t-PA) and plasminogen activator inhibitor-1( PAI-1) in pleural fluid at the first thoracentesis were measured with ELISA and D-dimer was measured with immunoturbidimetry. Results Eighty-four patients with pleural effusion were enrolled, among which 40 with malignant effusion, 33 with infectious effusion and 11 with transudative effusion. t-PA level was higher in malignant and transudative pleural fluid than that in infectious pleural fluid[ ( 52. 49 ±31. 46) ng /mL and ( 58. 12 ±23. 14) ng /mL vs ( 37. 39 ±22. 44) ng /mL, P lt; 0. 05] , but was not statistically different between malignant pleural fluid and transudative ( P gt; 0. 05) . PAI-1 level was higher in malignant and infectious pleural fluid than that in transudative [ ( 164. 86 ±150. 22) ng/mL and ( 232. 42 ±175. 77) ng/mL vs ( 46. 38 ±16. 13) ng/mL, P lt; 0. 01] , but was not statistically different between malignant and infectious pleural fluid( P gt;0. 05) . D-dimer levels in the three types of pleural fluid were significantly different, which was ( 23. 66 ±25. 18) mg/L, ( 6. 36 ±10. 87) mg/L and ( 66. 90 ±42. 17) mg/L in malignant, transudative and infectious pleural fluid, respectively. As single-item detection for malignant pleural fluid, the cutoff of t-PA was gt; 38. 7 ng/mL( area under ROC curve was 64. 0 ) , with sensitivity of 60. 0% , specificity of 63. 6%, positive predictive value of 66. 7%, negative predictive value of 56. 8% and accuracy of 61. 6% .The cutoff of D-dimer was lt; 27. 0 mg/L( area under ROC curve was 85. 5) , with sensitivity of 84. 8% ,specificity of 72. 5% , positive predictive value of 85. 3% , negative predictive value of 71. 8% and accuracy of78.1%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of combined examination( t-PA + D-dimer) were 92. 5% , 60. 6% , 74. 0% , 87. 0% , 78. 1% , respectively.Conclusions The t-PA, PAI-1 and D-dimer levels are significantly different in the three types of pleural fluid. The detection of fibrinolytic parameters in pleural fluid, especially the value of D-dimer,may be helpful in the differential diagnosis of pleural effusion.

    Release date:2016-09-14 11:23 Export PDF Favorites Scan
  • 重症脓毒症患者动态监测血乳酸及 D-二聚体的临床研究

    目的 动态观察外科重症脓毒症患者血清血乳酸及D-二聚体水平与预后的关系。方法回顾性分析55 例符合重症脓毒症标准的患者, 比较8、16、24、48、72 和168 h 的血乳酸变化和24、72、 168 h的D-二聚体变化。结果 其中34 例存活, 21 例死亡, 死亡率为38. 2%, 均死于多器官功能衰竭。 34 例存活组血乳酸48 h 内均达到正常, 而21 例死亡组直至第168 h仍明显高于存活组和正常值( P lt; 0. 05) 。死亡组24 h D-二聚体水平比存活组明显升高( 为正常值的5 倍) ( P lt;0. 05) , 在72 和168 h 两组无显著差异( P gt;0. 05) , 但两组D-二聚体仍明显升高( 为正常值的2. 5 倍) 。若以24 h 血乳酸和24 h D-二聚体预测死亡能力作ROC 曲线,24 h 血乳酸和D-二聚体的预测死亡能力相当。结论 动态监测1 周内血乳酸水平是判断重症脓毒症患者预后的一个重要指标, 血乳酸48 h 内降至正常, 预后良好; 随后的血乳酸仍高于正常, 预后差。24 h 血乳酸水平与24 h D-二聚体水平预测死亡能力相当。

    Release date:2016-09-14 11:24 Export PDF Favorites Scan
  • Pulmonary Embolism with Normal D-dimer Level: Nine Cases Report

    【Abstract】 Objective To improve the knowledge of pulmonary embolism with normal D-dimer levels. Methods Nine consecutive patients of established pulmonary embolism with a normal D-dimer concentration admitted from January 2004 to December 2009 were analyzed retrospectively. Results Pulmonary embolism was confirmed in the 9 patients with a normal D-dimer concentration. Pulmonary embolismwas confirmed in only one patientwith an unlikely probability of pulmonary embolism. Wells score was 3 and the localization of the emboli was segmental emboli. In other 8 patients with a likely clinical probability of pulmonary embolism, the complaints of those patients existed between 1 hour and 2 months.Wells score was between 4. 5 and 7. 5, with a median of 6. 0. D-dimer concentration was between 0. 1 and 0. 5 mg/L, with a median of 0. 3 mg/L. The localization of the emboli was sub-segmental emboli in 3 cases,segmental emboli in 4 cases, and central emboli in 2 cases. Conclusions Our findings indicate that it is essential to examine the patient and assess the clinical probability at the first, then the D-dimer concentration should be taken into account. In patients with a likely clinical probability, a normal D-dimer test result can not exclude pulmonary embolism, and additional imaging testing is necessary.

    Release date:2016-08-30 11:55 Export PDF Favorites Scan
  • 内源性硫化氢在肺栓塞患者中的表达及临床意义

    目的 探讨硫化氢( H2S) 在肺栓塞发病过程中的作用及与D-二聚体的关系。方法 在肺栓塞患者治疗前后应用ELISA 法检测外周血D-二聚体, 敏感硫电极方法检测血浆H2 S 水平。结果 肺栓塞患者抗凝治疗前血浆中H2S 水平高于正常对照组和抗凝治疗后( P lt;0. 05) 。抗凝治疗前血清中D-聚体含量明显增高, 与抗凝治疗前H2S 的变化呈正相关( r =0. 022) 。结论 内源性H2 S参与了肺栓塞的发生和发展, 与D-二聚体呈正相关。

    Release date:2016-09-13 04:07 Export PDF Favorites Scan
  • 心脏手术体外循环中心包血回输对凝血系统功能的影响

    摘要:  目的 探讨心脏手术体外循环(CPB) 中心包血回输对凝血系统功能的影响及作用。 方法 将24 例行二尖瓣置换术患者随机分为心包血回输组和心包血不回输组, 每组12 例。分别于术前5min、肝素化后10min、CPB30min 和CPB 结束时采集体循环血; CPB 结束时同时采集心包血。用酶联免疫吸附分析(ELISA ) 法检测组织因子(TF)、D-二聚体(D-D) 的血浆含量。 结果 两组体循环D-D 和TF 在CPB 30min、CPB 结束时分别较本组术前明显增高(P lt; 0. 05)。心包血不回输组体循环D-D 和TF 在CPB30min、CPB 结束时较心包血回输组明显降低, 两组比较差异有统计学意义(P lt; 0. 01)。两组心包血D-D 和TF 较同时循环血中D-D 和TF 明显升高(P lt; 0. 05) , 全血激活凝血时间(ACT) 缩短。 结论 直视心脏手术CPB 中心包血可激活凝血系统, TF 通过外源性凝血途径激活凝血系统。

    Release date:2016-08-30 06:08 Export PDF Favorites Scan
  • Evaluation of Quality of Chinese Literature on D-dimer Diagnostic Methodology

    Objective To evaluate the quality of Chinese literatures on the methodology of D-dimer diagnostic test. Method We searched CNKI (1994 to 2006) and CBM (1978 to 2006) for articles involving the diagnostic tests of D-dimer for coagulation disorders. Result A total of 63 relevant articles were retrieved and 7 were included in our review. Only one of these provided useful data on two two table for the evaluation of diagnostic accuracy. Conclusions Few studies on the diagnostic tests of D-dimer have been performed and publ ished in China, all of poor quality. Further studies should focus on clinical diagnostic sensitivity and specificity, so as to provide more valuable information for readers.

    Release date:2016-09-07 02:16 Export PDF Favorites Scan
  • D-二聚体水平测定在肺部疾病中的临床意义

    D-二聚体(D-dimmer)是血浆中交联纤维蛋白经纤溶酶水解所产生的一种特异性终末产物,当机体发生急性肺栓塞、肺癌、慢性阻塞性肺疾病、肺炎、急性呼吸窘迫综合征、慢性支气管炎、支气管哮喘等肺部疾病时会引发体内凝血机制的异常,血液呈高凝状态,继而引发纤溶系统亢进,观察患者的临床症状,积极检测D-二聚体水平的变化,对于疾病的诊断与治疗有着重要的参考价值 。现对近年来有关检测D-二聚体水平与肺部疾病关系的文献进行搜集整理,分析D-二聚体水平测定在肺部疾病的预防、诊断、治疗以及疗效的判断和预后方面的价值。

    Release date:2016-09-07 02:34 Export PDF Favorites Scan
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