BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To inves...BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for...BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.展开更多
Objective: To investigate the expression and diagnostic value of D-dimer, CRP, and IL-6 in children with Mycoplasma pneumonia. Methods: A total of 100 children diagnosed with Mycoplasma pneumonia from the pediatric de...Objective: To investigate the expression and diagnostic value of D-dimer, CRP, and IL-6 in children with Mycoplasma pneumonia. Methods: A total of 100 children diagnosed with Mycoplasma pneumonia from the pediatric department of the First Affiliated Hospital of Shaoyang University, admitted between November 2023 and June 2024, were selected for the study. According to the severity of the condition, they were divided into two groups: a mild group (50 cases) and a severe group (50 cases). After treatment, they were further divided into an effective group (63 cases) and a non-effective group (37 cases) based on the treatment outcomes, to compare their diagnostic values. Results: The levels of D-dimer, CRP, IL-6, length of hospital stay, fever resolution time, cough resolution time, and the time for lung rales to disappear were higher in the severe group than in the mild group (P < 0.05). The levels of D-dimer, CRP, and IL-6 in the non-effective group were higher than those in the effective group (P < 0.05). In this study, using pathological results as the “gold standard,” it was found that the positive detection rate for the combined detection of D-dimer, CRP, and IL-6 was higher than the detection rate for each of D-dimer, CRP, and IL-6 alone, suggesting that the combined diagnosis had a higher positive detection rate (P < 0.05). Compared with D-dimer, CRP, and IL-6, the combined sensitivity, specificity, and accuracy were all higher (P < 0.05). Conclusion: D-dimer, CRP, and IL-6 are closely related to Mycoplasma pneumonia in children and can serve as auxiliary diagnostic tools for Mycoplasma pneumonia in children, offering significant value.展开更多
BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Alt...BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Although blood culture is the gold standard for diagnosis,it is not always positive.AIM To evaluate the diagnostic and prognostic utility of D-dimer and heparin-binding protein(HBP)in neonatal sepsis.METHODS This prospective case-control study included 90 neonates in two groups:A sepsis group(n=45)and a control group(n=45)without sepsis.Sepsis group was further subdivided based on blood culture results into proven sepsis(n=28 culturepositive sepsis)and suspected sepsis(n=17 culture-negative sepsis).All neonates underwent complete history taking,thorough clinical examination and investigations[complete blood count,C-reactive protein(CRP),liver and kidney function tests,plasma D-dimer and HBP].RESULTS Levels of CRP,D-dimer and HBP were significantly higher in the sepsis group compared to the controls.At a cutoff value above 517.9 ng/mL,D-dimer outperformed CRP and HBP in distinguishing sepsis group from controls with 95.6%sensitivity and 97.8%specificity.D-dimer was also a better prognostic marker than the neonatal sequential organ failure assessment(nSOFA)for predicting mortality,with 100%sensitivity and 92.5%specificity vs 80%sensitivity and 82.5%specificity.There was a significant positive correlation between CRP,D-dimer and HBP.CONCLUSION D-dimer demonstrated superior diagnostic accuracy compared to CRP and HBP in predicting sepsis,and demonstrated superior prognostic accuracy compared to nSOFA in predicting the outcome of neonatal sepsis.展开更多
BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for th...BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.展开更多
BACKGROUND The utility of D-dimer(DD)as a biomarker for acute aortic dissection(AD)is recognized.Yet,its predictive value for in-hospital mortality remains uncertain and subject to conflicting evidence.AIM To conduct ...BACKGROUND The utility of D-dimer(DD)as a biomarker for acute aortic dissection(AD)is recognized.Yet,its predictive value for in-hospital mortality remains uncertain and subject to conflicting evidence.AIM To conduct a meta-analysis of AD-related in-hospital mortality(ADIM)with elevated DD levels.METHODS We searched PubMed,Scopus,Embase,and Google Scholar for AD and ADIM literature through May 2022.Heterogeneity was assessed using I2 statistics and effect size(hazard or odds ratio)analysis with random-effects models.Sample size,study type,and patients’mean age were used for subgroup analysis.The significance threshold was P<0.05.RESULTS Thirteen studies(3628 patients)were included in our study.The pooled prevalence of ADIM was 20%(95%CI:15%-25%).Despite comparable demographic characteristics and comorbidities,elevated DD values were associated with higher ADIM risk(unadjusted effect size:1.94,95%CI:1.34-2.8;adjusted effect size:1.12,95%CI:1.05-1.19,P<0.01).Studies involving patients with a mean age of<60 years exhibited an increased mortality risk(effect size:1.43,95%CI:1.23-1.67,P<0.01),whereas no significant difference was observed in studies with a mean age>60 years.Prospective and larger sample size studies(n>250)demonstrated a heightened likelihood of ADIM associated with elevated DD levels(effect size:2.57,95%CI:1.30-5.08,P<0.01 vs effect size:1.05,95%CI:1.00-1.11,P=0.05,respectively).CONCLUSION Our meta-analysis shows elevated DD increases in-hospital mortality risk in AD patients,highlighting the need for larger,prospective studies to improve risk prediction models.展开更多
BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the...BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.展开更多
Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and...Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre-eclampsia with severe features. Furthermore, the cut-off point of a D-dimer level of 0.66 µg/ml significantly predicts postpartum hemorrhage with a sensitivity of 75% and specificity of 55%. For those who had no severe features the cut-off point was 0.53 µg/ml with a sensitivity of 95% and specificity of 53%, and for those who had severe features the cut-off point was 3.58 µg/ml with a sensitivity of 50% and specificity of 96%. Conclusion: D-dimer can be used to predict postpartum hemorrhage among pre-eclampsia, especially among those who have severe features. This shows that D-dimer has specificity in predicting PPH in women with pre-eclampsia and can be applied in clinical services to save women from maternal morbidity and mortality. Blood products such as fresh frozen plasma, platelets, and whole blood together with tranexamic acid should be readily available in women with pre-eclampsia especially those with severe features with a D-dimer level of 3.58 µg/ml and above during delivery as they are at high risk of developing PPH.展开更多
Objective:To analyze the value of D-dimer(D-D),interleukin-6(IL-6),and IL-18 in the differential diagnosis of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods:The medical records of 92 children w...Objective:To analyze the value of D-dimer(D-D),interleukin-6(IL-6),and IL-18 in the differential diagnosis of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods:The medical records of 92 children with Mycoplasma pneumoniae pneumonia(MPP)treated in the hospital were selected for retrospective analysis from January 2023 to January 2024.After comprehensive examinations such as computed tomography examination of the chest,48 children with general Mycoplasma pneumoniae pneumonia(GMPP)were put in the GMPP group and 44 children with RMPP were grouped in the RMPP group.The IL-6,IL-18,and D-D levels were compared between the two groups,and the receiver operating characteristic(ROC)curves were plotted to analyze their value for differential diagnosis of RMPP.Results:The levels of IL-6,IL-18,and D-D in the RMPP group were higher than those in the GMPP group(P<0.05);the ROC curves showed that the specificity of the differential diagnosis of IL-6,IL-18,and D-D was higher,and their diagnostic value was significant.Conclusion:Determination of IL-6,IL-18,and D-D levels in children with MPP can further diagnose the children’s condition,which can help physicians formulate targeted treatment plans,and is of great significance to the improvement of the children’s condition,which is worthy of attention.展开更多
Objective:To explore the correlation between the change of D-dimer level and rheumatoid arthritis complicated with interstitial lung disease.Methods:From January 2022 to February 2024,20 rheumatoid arthritis patients ...Objective:To explore the correlation between the change of D-dimer level and rheumatoid arthritis complicated with interstitial lung disease.Methods:From January 2022 to February 2024,20 rheumatoid arthritis patients complicated with interstitial lung disease(interstitial lung disease group),20 rheumatoid arthritis patients without interstitial lung disease(without interstitial lung disease group),and 20 healthy people(control group)in Xijing Hospital were selected for this study.The fasting venous blood of the three groups of subjects was collected and their D-dimer,C-reactive protein(CRP),rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)were detected.Subsequently,the correlation between each index and rheumatoid arthritis complicated with interstitial lung disease was analyzed.Results:The D-dimer level of the interstitial lung disease group was significantly higher than the other two groups(P<0.05).The D-dimer level of the group without interstitial lung disease was significantly higher than the control group(P<0.05).CRP levels in the interstitial lung disease group and the group without interstitial lung disease were significantly higher than those of the control group(P<0.05).The ESR and RF levels of the interstitial lung disease group were significantly higher than the other two groups(P<0.05).The levels of ESR and RF levels of the group without interstitial lung disease were significantly higher than the control group(P<0.05).Conclusion:D-dimer levels of rheumatoid arthritis patients are higher than those of healthy individuals,and those complicated with interstitial lung disease present even higher levels.This finding shows that there is a correlation between D-dimer levels and rheumatoid arthritis with interstitial lung disease,which may facilitate the evaluation and diagnosis of this disease.展开更多
Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided in...Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided into model group （n = 10）, EA group （n = 10）, normal group （n = 10）, and sham operation group （n = 10）. The model of acute cerebral infarction was established by blocking the middle cerebral artery with an intraluminal thread. EA was applied at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟GV 26） in the rats of EA group after the models were developed. The contents of D-dimer （D-D） and fibrinogen （Fib） were measured in each group. Results The contents of D-D and Fib increased signifi- cantly in model group as compared with normal and sham operation groups, respectively （P〈0.01）, and they decreased significantly in EA group as compared with model group （P〈0.01）. Conclusion EA can ob-viously decrease the contents of D-D and Fib, improve abnormal fibrinolysis, lower blood viscosity and ameliorate cerebral blood circulation in the rats with acute cerebral infarction.展开更多
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.
文摘Objective: To investigate the expression and diagnostic value of D-dimer, CRP, and IL-6 in children with Mycoplasma pneumonia. Methods: A total of 100 children diagnosed with Mycoplasma pneumonia from the pediatric department of the First Affiliated Hospital of Shaoyang University, admitted between November 2023 and June 2024, were selected for the study. According to the severity of the condition, they were divided into two groups: a mild group (50 cases) and a severe group (50 cases). After treatment, they were further divided into an effective group (63 cases) and a non-effective group (37 cases) based on the treatment outcomes, to compare their diagnostic values. Results: The levels of D-dimer, CRP, IL-6, length of hospital stay, fever resolution time, cough resolution time, and the time for lung rales to disappear were higher in the severe group than in the mild group (P < 0.05). The levels of D-dimer, CRP, and IL-6 in the non-effective group were higher than those in the effective group (P < 0.05). In this study, using pathological results as the “gold standard,” it was found that the positive detection rate for the combined detection of D-dimer, CRP, and IL-6 was higher than the detection rate for each of D-dimer, CRP, and IL-6 alone, suggesting that the combined diagnosis had a higher positive detection rate (P < 0.05). Compared with D-dimer, CRP, and IL-6, the combined sensitivity, specificity, and accuracy were all higher (P < 0.05). Conclusion: D-dimer, CRP, and IL-6 are closely related to Mycoplasma pneumonia in children and can serve as auxiliary diagnostic tools for Mycoplasma pneumonia in children, offering significant value.
基金Supported by National Liver Institute,Menoufia University,and Damietta General Hospital,Damietta,Egypt.
文摘BACKGROUND Neonatal sepsis is a serious health problem,with high morbidity and mortality during the first 28 days of life.Clinical diagnosis at presentation is challenging due to the nonspecific signs and symptoms.Although blood culture is the gold standard for diagnosis,it is not always positive.AIM To evaluate the diagnostic and prognostic utility of D-dimer and heparin-binding protein(HBP)in neonatal sepsis.METHODS This prospective case-control study included 90 neonates in two groups:A sepsis group(n=45)and a control group(n=45)without sepsis.Sepsis group was further subdivided based on blood culture results into proven sepsis(n=28 culturepositive sepsis)and suspected sepsis(n=17 culture-negative sepsis).All neonates underwent complete history taking,thorough clinical examination and investigations[complete blood count,C-reactive protein(CRP),liver and kidney function tests,plasma D-dimer and HBP].RESULTS Levels of CRP,D-dimer and HBP were significantly higher in the sepsis group compared to the controls.At a cutoff value above 517.9 ng/mL,D-dimer outperformed CRP and HBP in distinguishing sepsis group from controls with 95.6%sensitivity and 97.8%specificity.D-dimer was also a better prognostic marker than the neonatal sequential organ failure assessment(nSOFA)for predicting mortality,with 100%sensitivity and 92.5%specificity vs 80%sensitivity and 82.5%specificity.There was a significant positive correlation between CRP,D-dimer and HBP.CONCLUSION D-dimer demonstrated superior diagnostic accuracy compared to CRP and HBP in predicting sepsis,and demonstrated superior prognostic accuracy compared to nSOFA in predicting the outcome of neonatal sepsis.
文摘BACKGROUND Gestational diabetes mellitus(GDM)is a special type of diabetes that commonly occurs in women during pregnancy and involves impaired glucose tolerance and abnormal glucose metabolism;GDM is diagnosed for the first time during pregnancy and can affect fetal growth and development.AIM To investigate the associations of serum D-dimer(D-D)and glycosylated hemoglobin(HbA1c)levels with third-trimester fetal growth restriction(FGR)in GDM patients.METHODS The clinical data of 164 pregnant women who were diagnosed with GDM and delivered at the Obstetrics and Gynecology Hospital of Fudan University from January 2021 to January 2023 were analyzed retrospectively.Among these women,63 whose fetuses had FGR were included in the FGR group,and 101 women whose fetuses had normal body weights were included in the normal body weight group(normal group).Fasting venous blood samples were collected from the elbow at 28-30 wk gestation and 1-3 d before delivery to measure serum D-D and HbA1c levels for comparative analysis.The diagnostic value of serum D-D and HbA1c levels for FGR was evaluated by receiver operating characteristic analysis,and the influencing factors of third-trimester FGR in GDM patients were analyzed by logistic regression.RESULTS Serum fasting blood glucose,fasting insulin,D-D and HbA1c levels were significantly greater in the FGR group than in the normal group,while the homeostasis model assessment of insulin resistance values were lower(P<0.05).Regarding the diagnosis of FGR based on serum D-D and HbA1c levels,the areas under the curves(AUCs)were 0.826 and 0.848,the cutoff values were 3.04 mg/L and 5.80%,the sensitivities were 81.0%and 79.4%,and the specificities were 88.1%and 87.1%,respectively.The AUC of serum D-D plus HbA1c levels for diagnosing FGR was 0.928,and the sensitivity and specificity were 84.1%and 91.1%,respectively.High D-D and HbA1c levels were risk factors for third-trimester FGR in GDM patients(P<0.05).CONCLUSION D-D and HbA1c levels can indicate the occurrence of FGR in GDM patients in the third trimester of pregnancy to some extent,and their combination can be used as an important index for the early prediction of FGR.
文摘BACKGROUND The utility of D-dimer(DD)as a biomarker for acute aortic dissection(AD)is recognized.Yet,its predictive value for in-hospital mortality remains uncertain and subject to conflicting evidence.AIM To conduct a meta-analysis of AD-related in-hospital mortality(ADIM)with elevated DD levels.METHODS We searched PubMed,Scopus,Embase,and Google Scholar for AD and ADIM literature through May 2022.Heterogeneity was assessed using I2 statistics and effect size(hazard or odds ratio)analysis with random-effects models.Sample size,study type,and patients’mean age were used for subgroup analysis.The significance threshold was P<0.05.RESULTS Thirteen studies(3628 patients)were included in our study.The pooled prevalence of ADIM was 20%(95%CI:15%-25%).Despite comparable demographic characteristics and comorbidities,elevated DD values were associated with higher ADIM risk(unadjusted effect size:1.94,95%CI:1.34-2.8;adjusted effect size:1.12,95%CI:1.05-1.19,P<0.01).Studies involving patients with a mean age of<60 years exhibited an increased mortality risk(effect size:1.43,95%CI:1.23-1.67,P<0.01),whereas no significant difference was observed in studies with a mean age>60 years.Prospective and larger sample size studies(n>250)demonstrated a heightened likelihood of ADIM associated with elevated DD levels(effect size:2.57,95%CI:1.30-5.08,P<0.01 vs effect size:1.05,95%CI:1.00-1.11,P=0.05,respectively).CONCLUSION Our meta-analysis shows elevated DD increases in-hospital mortality risk in AD patients,highlighting the need for larger,prospective studies to improve risk prediction models.
基金This study was reviewed and approved by the Ethics Committee of the Kobe University Graduate School of Medicine(Provided ID Number:B210306).
文摘BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.
文摘Background: Postpartum hemorrhage (PPH) is the major contributor to maternal mortality and morbidity worldwide as well as in Tanzania. Studies have shown Pre-eclampsia as a risk indicator for Postpartum hemorrhage and D-dimer tends to rise in women with pre-eclampsia. Few studies that have shown the association between D-dimer and PPH have been controversial and differ according to ethnicity and lifestyle. Hence there is no suitable reference interval for D-dimer in predicting Postpartum hemorrhage among women with pre-eclampsia. Broad Objective: This study aimed to assess the association, sensitivity, and specificity of D-dimer as a laboratory predictor of postpartum hemorrhage among women with pre-eclampsia at KCMC hospital. Methodology: This was a hospital-based analytical cross-sectional study conducted at KCMC Hospital in Northern Tanzania from September 2022 to March 2023. A total of 195 women with pre-eclampsia were included in this study. Plasma D-dimer levels were taken from women with pre-eclampsia pre-delivery. Haematocrit was compared before and after delivery, and a fall of 10% was considered as Postpartum hemorrhage together with clinical assessment of the patient. Participants were divided among those who had severe features and those who did not have severe features and were further categorized into those who had PPH and those who did not have PPH. Logistic regression was used to determine the association between D-dimer and PPH adjusting for other factors. The Receiver Operating Curve (ROC) was used to evaluate the predictive value. Results: Higher median D-dimer levels were seen among women who had PPH compared to those who had no PPH. D-dimer was seen to be associated with PPH, thus for every unit increase of µg/ml of D-dimer among women who had pre-eclampsia without severe features there was a 14% significant increase in the odds of having postpartum hemorrhage and a 45% significant increase of having postpartum hemorrhage among those who had pre-eclampsia with severe features. Furthermore, the cut-off point of a D-dimer level of 0.66 µg/ml significantly predicts postpartum hemorrhage with a sensitivity of 75% and specificity of 55%. For those who had no severe features the cut-off point was 0.53 µg/ml with a sensitivity of 95% and specificity of 53%, and for those who had severe features the cut-off point was 3.58 µg/ml with a sensitivity of 50% and specificity of 96%. Conclusion: D-dimer can be used to predict postpartum hemorrhage among pre-eclampsia, especially among those who have severe features. This shows that D-dimer has specificity in predicting PPH in women with pre-eclampsia and can be applied in clinical services to save women from maternal morbidity and mortality. Blood products such as fresh frozen plasma, platelets, and whole blood together with tranexamic acid should be readily available in women with pre-eclampsia especially those with severe features with a D-dimer level of 3.58 µg/ml and above during delivery as they are at high risk of developing PPH.
文摘Objective:To analyze the value of D-dimer(D-D),interleukin-6(IL-6),and IL-18 in the differential diagnosis of children with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods:The medical records of 92 children with Mycoplasma pneumoniae pneumonia(MPP)treated in the hospital were selected for retrospective analysis from January 2023 to January 2024.After comprehensive examinations such as computed tomography examination of the chest,48 children with general Mycoplasma pneumoniae pneumonia(GMPP)were put in the GMPP group and 44 children with RMPP were grouped in the RMPP group.The IL-6,IL-18,and D-D levels were compared between the two groups,and the receiver operating characteristic(ROC)curves were plotted to analyze their value for differential diagnosis of RMPP.Results:The levels of IL-6,IL-18,and D-D in the RMPP group were higher than those in the GMPP group(P<0.05);the ROC curves showed that the specificity of the differential diagnosis of IL-6,IL-18,and D-D was higher,and their diagnostic value was significant.Conclusion:Determination of IL-6,IL-18,and D-D levels in children with MPP can further diagnose the children’s condition,which can help physicians formulate targeted treatment plans,and is of great significance to the improvement of the children’s condition,which is worthy of attention.
文摘Objective:To explore the correlation between the change of D-dimer level and rheumatoid arthritis complicated with interstitial lung disease.Methods:From January 2022 to February 2024,20 rheumatoid arthritis patients complicated with interstitial lung disease(interstitial lung disease group),20 rheumatoid arthritis patients without interstitial lung disease(without interstitial lung disease group),and 20 healthy people(control group)in Xijing Hospital were selected for this study.The fasting venous blood of the three groups of subjects was collected and their D-dimer,C-reactive protein(CRP),rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)were detected.Subsequently,the correlation between each index and rheumatoid arthritis complicated with interstitial lung disease was analyzed.Results:The D-dimer level of the interstitial lung disease group was significantly higher than the other two groups(P<0.05).The D-dimer level of the group without interstitial lung disease was significantly higher than the control group(P<0.05).CRP levels in the interstitial lung disease group and the group without interstitial lung disease were significantly higher than those of the control group(P<0.05).The ESR and RF levels of the interstitial lung disease group were significantly higher than the other two groups(P<0.05).The levels of ESR and RF levels of the group without interstitial lung disease were significantly higher than the control group(P<0.05).Conclusion:D-dimer levels of rheumatoid arthritis patients are higher than those of healthy individuals,and those complicated with interstitial lung disease present even higher levels.This finding shows that there is a correlation between D-dimer levels and rheumatoid arthritis with interstitial lung disease,which may facilitate the evaluation and diagnosis of this disease.
基金subsidized by the research project item of the Department of Educationin Hubei Province:No.D200516006
文摘Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided into model group （n = 10）, EA group （n = 10）, normal group （n = 10）, and sham operation group （n = 10）. The model of acute cerebral infarction was established by blocking the middle cerebral artery with an intraluminal thread. EA was applied at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟GV 26） in the rats of EA group after the models were developed. The contents of D-dimer （D-D） and fibrinogen （Fib） were measured in each group. Results The contents of D-D and Fib increased signifi- cantly in model group as compared with normal and sham operation groups, respectively （P〈0.01）, and they decreased significantly in EA group as compared with model group （P〈0.01）. Conclusion EA can ob-viously decrease the contents of D-D and Fib, improve abnormal fibrinolysis, lower blood viscosity and ameliorate cerebral blood circulation in the rats with acute cerebral infarction.
