摘要
目的 研究分析D-二聚体水平检测对急性缺血性肠病的诊断价值,为临床缺血性肠病的诊断、控制寻找更经济、有效的检测手段。方法 选取2014年10月至2015年10月接诊的95例疑似急性缺血性肠病患者为观察组,另选取同期来例行体检的健康人74例作为对照组,比较对照组与确诊为急性缺血性肠病的观察组患者入院后第1、7、14天的D-二聚体水平差异,同时对比两组起始白细胞水平、大便潜血情况差异,计算血浆D-二聚体水平在早期诊断急性缺血性肠病中的灵敏度和特异度并总结其临床应用价值。结果 （1）依据血浆D-二聚体结果,诊断为急性缺血性肠病阳性患者74例,阴性患者21例,采用肠系膜下动脉血管造影CT检测及多层螺旋CT检查确诊共有80例阳性患者、15例阴性患者,血浆D-二聚体检测灵敏度为88.75%、特异度为80.0%。（2）观察组患者入院第1天D-二聚体水平、白细胞数、大便潜血阳性率分别为（5 480.12±876.32）μg/L、（17.37±2.21）×109/L、81.3%,远远高于健康对照组,差异有统计学意义（P〈0.05）。（3）观察组患者入院第1、7、14天D-二聚体水平明显高于对照组（P〈0.05）,随着治疗时间的延长,其血浆D-二聚体水平逐渐降低。结论 D-二聚体检测在早期诊断急性缺血性肠病方面具有相对较高的灵敏度和特异度,具备良好的临床应用价值。
Objective To study the value of D‐dimer for early diagnosing ischemic bowel disease（IBD） and to find more econom‐ic and more effective detection means for its diagnosis and control .Methods Ninety‐five patients with suspected acute IBD in our hospital from October 2014 to October 2015 were selected as the observation group ,and contemporaneous 74 individuals undergoing routine physical examination were selected as the control group .The differences in D‐dimer levels were compared between the con‐trol group and the patients with definitely diagnosed IBD in the observation group on 1 ,7 ,14 d after admission .At the same time the differences in initial WBC level and fecal occult blood were compared between the two groups .The sensitivity and specificity of plas‐ma D‐dimer level for early diagnosing IBD were calculated and their clinical application value was summarized .Results （1） Accord‐ing to plasma D‐dimer results ,the 74 cases of acute IBD were diagnosed and 21 cases were negative ,while 80 positive cases and 15 negative cases were diagnosed by adopting the CT inferior mesenteric arterial angiography and multislice spiral CT ,the sensitivity of plasma D‐dimer detection was 88 .75% and specificity was 80 .0% .（2） The D‐dimer level ,WBC count and fecal occult blood on 1 d after admission in the observation group were （5 480 .12 ±876 .32）μg/L ,（17 .37 ±2 .21） ＆215; 109/L and 81 .3% respectively ,which were far higher than those in the healthy control group ,the differences were statistically significant （P〈0 .05） .（3）The D‐dimer levels on 1 ,7 ,14 d after admission in the observation group were significantly higher than those in the control group （P〈0 .05） , while with the treatment duration extension ,the plasma D‐dimer level was gradually decreased .Conclusion The D‐dimer detection has a relatively higher sensitivity and specificity in the early diagnosis of acute IBD and has better clinical application value .
出处
《国际检验医学杂志》
CAS
2016年第16期2258-2259,2262,共3页
International Journal of Laboratory Medicine
