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多发伤患者D-二聚体的变化及临床意义
Hits: 1834   Download times: 1490   Received:January 17, 2004    
作者Author单位UnitE-Mail
刘波 LIU Bo 舟山市人民医院血液室 浙江舟山316004 The People’s Hospital of Zhoushan,Zhoushan 316004,Zhejiang,China  
金秀国 JIN Xiu-guo 舟山市人民医院血液室 浙江舟山316004 The People’s Hospital of Zhoushan,Zhoushan 316004,Zhejiang,China  
刘晓光 LIU Xiao-guang 舟山市人民医院血液室 浙江舟山316004 The People’s Hospital of Zhoushan,Zhoushan 316004,Zhejiang,China  
庄晓玲 ZHUANG Xiao-ling 舟山市人民医院血液室 浙江舟山316004 The People’s Hospital of Zhoushan,Zhoushan 316004,Zhejiang,China  
方汉波 FANG Han-bo 舟山市人民医院血液室 浙江舟山316004 The People’s Hospital of Zhoushan,Zhoushan 316004,Zhejiang,China  
方国安 FANG Guo-an 舟山市人民医院血液室 浙江舟山316004 The People’s Hospital of Zhoushan,Zhoushan 316004,Zhejiang,China  
期刊信息:《中国骨伤》2005年18卷,第12期,第730-732页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:研究血浆D-二聚体及纤维蛋白原在多发伤时的变化及临床意义。

方法:以创伤严重程度等级(ISS)评分16分为界,将49例多发伤患者分为轻伤组(ISS≤16分)和重伤组(ISS>16分),并以30例正常人为对照组,采用免疫胶体金法及仪器法检测了正常人和多发伤患者受伤第1、2及3天的血浆D-二聚体和纤维蛋白原浓度。

结果:多发伤后血浆D-二聚体明显增高,且重伤组高于轻伤组(均P<0.01),第2、3天明显低于第1天(P<0.01),但仍高于对照组(P<0.01)。纤维蛋白原重伤组第1天与对照组比较无统计学差异(P>0.05),轻伤组明显高于对照组和重伤组(P<0.01)。伤后第2、3天均明显高于第1天(P<0.01),并且高于对照组(P<0.01)。伤后第1、2、3天纤维蛋白原的含量与D-二聚体呈负相关(r=-0.591,r=0.548,r=-0.470,P<0.01)。

结论:多发伤患者存在高凝状态和继发性纤溶亢进,血浆D-二聚体的浓度与病情、病程密切相关。重型多发伤初期纤维蛋白原不增高与纤溶增强有关。
[关键词]:创伤和损伤  D-二聚体  纤维蛋白原
 
Changes of D-dimer contents in plasma of the patients with multiple injuries and its clinical significance
Abstract:

Objective: To investigate the changes of D-dimer and fibrinogen contents in plasma of the patients with multiple injuries and to explore its clinical significance.

Methods:According to injury severity score(ISS),49 patients were divided into 2 groups:slight trauma group(ISS≤16) and severe trauma goup(ISS>16).Thirty normal persons were recruited into control group.By using immunometic and the machine called ACL-2000,the contents of D-dimer and fibrinogen in plasma of above three groups were detected at the 1st,2nd and 3rd days after wounds.

Results:The contents of D-dimer in plasma of the patients increased significantly after wounds.Compared with slight trauma group,the content of D-dimer in severe trauma group was significantly higher(P<0.01).The contents of D-dimer in the patients were lower at 2nd and 3rd days after wounds than that at 1st day,but it still higher than that of control group(P<0.01).At the 1st day after wounds,the content of fibrinogen in plasma of severe trauma group had no statistical difference from control group,but that in slight trauma group was higher than those of control and severe trauma groups(P<0.01).At 2nd and 3rd days after wounds,the contents of fibrinogen in the patients increased and were higher than that at 1st day and of control group(P<0.01).The contents of fibrinogen in plasma of the patients were negatively correlated with the contents of D-dimer at the 1st,2nd and 3rd days after wounds(r=-0.591,r=0.548,r=-0.470,P<0.01).



Conclusion:
Hypercoagulable state and the secondary hyperfibrinolysis can be observed in the patients with multiple injuries.The levels of D-dimer in plasma of the patients were closely associated with their injury conditions and development.The low level of fibrinogen in the serious trauma group is related to intensify of fibrinolysis at early stage after wounds.
KEYWORDS:Wounds and injuries  D-dimer  Fibrinogen
 
引用本文,请按以下格式著录参考文献:
中文格式:刘波,金秀国,刘晓光,庄晓玲,方汉波,方国安.多发伤患者D-二聚体的变化及临床意义[J].中国骨伤,2005,18(12):730~732
英文格式:LIU Bo,JIN Xiu-guo,LIU Xiao-guang,ZHUANG Xiao-ling,FANG Han-bo,FANG Guo-an.Changes of D-dimer contents in plasma of the patients with multiple injuries and its clinical significance[J].zhongguo gu shang / China J Orthop Trauma ,2005,18(12):730~732
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