D-二聚体水平检测对过敏性紫癜患者的临床诊疗价值被引量：14

Clinical Value of Detecting the Level of D-dimer in Diagnosis and Treatment of the Patients with Henoch-Schonlein Purpura

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摘要目的探讨D-二聚体检测在过敏性紫癜(HSP)临床诊断及治疗中的应用效果.方法选取北方学院附属第一医院2014年01月至2015年12月住院患者共200例为病例组;检测病例组D-二聚体阳性93例,根据治疗方案将病例组D-二聚体阳性患者分为银杏达莫组(26例),糖皮质激素组(37例)及联合组(30例)3组,另选取200例体检健康者作为对照组.检测所有研究对象血浆D-二聚体的水平,观察不同治疗方案的临床治疗效果,分析D-二聚体与患者病情的关系.结果病例组D-二聚体阳性率及浓度均明显高于对照组,差异具有统计学意义(P<0.05);D-二聚体阳性率单纯型占5.5%、肾型占9.5%、腹型占8.5%、关节型AP占6.5%、混合型占16.5%.银杏达莫组临床有效率为69.2%,糖皮质激素组临床有效率为70.3%,联合组临床有效率为93.3%,联合组临床有效率明显高于其他2组,差异有统计学意义(P<0.05).治疗后联合组D-二聚体含量明显低于银杏达莫组和糖皮质激素组,治疗前后差值明显高于其它2组,差异有统计学意义(P<0.05).结论对HSP患者进行D-二聚体检测可以有助于病情进展的判断,根据患者的具体情况采取有效的、早期的、联合的治疗措施,对患者诊断、治疗及预后评估具有十分重要的临床价值. Objective To investigate the clinica lapllication effect of D-dimer detection in Henoch Schonlein group; D- dimer of 93 cases in patient group was detected positive, and according to treatment protocol, the positive patients on D-dimer detection were divided into three groups： ginkgo dipyridolum group （26 cases） , glucocorticoid group （37 cases） and combined group （30 cases） , another 200 healthy cases were selected as control group. We detected D-dimer level in study objects, observed the clinical treatment effect of different treatment plan, analyzed the relationship between D- dimer and disease. Results group was significantly higher than that of the control group The positive rate and D- dimer concentration in patient , the difference was statistically significant （P〈0.05） . The positive rate D-dime in simple type was 5.5%, in kidney type was 9.5%, in abdominal type was 8.5%, in joint type was 6.5%, and in mixed type was 16.5%. The clinical effective rate in Yinxingdamo group was 69.2%, the glucocortieoid Pigment group was 70.3%, and the combined group was 93.3%, the clinical effective rate of the combined group was significantly higher than that of Yinxingdamo group and glucocorticoid group, the difference was statistically significant （P〈O.05） ; after treatment the D-dimer content in combined group was significantly lower than that of Yinxingdamo group and glucocorticoid group, The difference between before and after treatment was significantly higher than that in the other two groups, the difference is statistically significant （P 〈0.05） Gonelusiorl D-dimer can help the judgment on the progress of disease in patients admitted to hospital, it has important value in diagnosis , treatment and evaluation of prognosis to take effective, early, combined treatment measures according to the specific circumstances.