高龄老年血栓性疾病患者血浆D-二聚体水平及抗凝治疗效果分析
Analysis of plasma D-dimer levels and anticoagulant therapy effects in elderly patients with thrombotic diseases
武云涛 1陈艳梅 1刘立新 1姚璐 1田国祥 1黄勇华2
作者信息
- 1. 100700 北京,中国人民解放军总医院第七医学中心老年医学科
- 2. 100700 北京,中国人民解放军总医院第七医学中心神经内科
- 折叠
摘要
目的 探讨高龄老年血栓性疾病患者血浆D-二聚体(DD)水平及抗凝治疗效果分析.方法 收集2014年1月至2022年12间于解放军总医院第七医学中心老年医学科住院的高龄老年患者,根据是否合并急性血栓性疾病分为:观察组(180例,合并血栓性疾病)和对照组(182例,未合并血栓性疾病).比较两组患者的DD水平及阳性率,同时分析观察组中不同血栓性疾病亚组患者的血浆DD水平及阳性率.结果 观察组患者血浆DD平均水平明显高于对照组[(6.72±0.51)mg/L vs.(0.21±0.08)mg/L,(P＜0.01)].观察组患者血浆DD阳性检出率明显高于对照组[(100.0%vs.6.59%),(P＜0.01)].急性肺栓塞亚组、急性下肢深静脉血栓亚组血浆DD平均水平明显高于急性心肌梗死亚组和急性脑梗死亚组(P＜0.05),而急性下肢深静脉血栓亚组和急性肺栓塞亚组间无明显差异(P＞0.05).急性心肌梗死组与急性脑梗死亚组间DD平均水平无明显统计学差异(P＞0.05).启动抗凝或加强抗凝治疗后1周监测血浆DD水平较血栓形成时明显降低(P＜0.01),与观察组比较,血浆DD阳性率无统计学差异(P＞0.05).结论 DD是高龄老年患者血栓性疾病和高凝状态的特异性指标,入院常规检测,可及时发现是否有血栓形成或处于高凝状态,对于指导临床血栓性疾病的诊断和是否启动抗凝及加强抗凝治疗具有重要指导意义.
Abstract
Objective The purpose of this study is to explore the plasma D-dimer(DD)levels and anticoagulant therapy effects in elderly patients with thrombotic diseases.Method Elderly patients admitted to the Geriatrics Department of the Seventh Medical Center of the General Hospital of the People's Liberation Army from January 2014 to December 2022 were collected.They were divided into an observation group(180 cases,with thrombotic disease)and a control group(182 cases,without thrombotic disease)based on whether acute thrombotic disease was present.Compare the DD levels and positive rates between two groups of patients,and analyze the plasma DD levels and positive rates of patients in different subgroups of thrombotic diseases in the observation group.Results The average level of plasma DD in the observation group was significantly higher than that in the control group[(6.72±0.51)mg/L vs.(0.21±0.08)mg/L,P<0.01)].The positive detection rate of plasma DD in the observation group was significantly higher than that in the control group(100.0%vs.6.59%),(P<0.01).The average plasma DD levels in the subgroups of acute pulmonary embolism and acute lower limb deep vein thrombosis were significantly higher than those in the subgroups of acute myocardial infarction and acute cerebral infarction(P<0.05),while there was no significant difference between the subgroups of acute lower limb deep vein thrombosis and acute pulmonary embolism(P>0.05).There was no significant statistical difference in the average level of DD between the acute myocardial infarction group and the acute cerebral infarction group(P>0.05).One week after initiating or strengthening anticoagulation,the plasma DD level was significantly reduced compared to when thrombosis occurred(P<0.01).Compared with the observation group,there was no statistically significant difference in the plasma DD positive rate(P>0.05).Conclusion DD is a specific indicator of thrombotic disease and hypercoagulable state in elderly patients.Routine examination upon admission can timely detect the presence of thrombosis or hypercoagulable state,which has important guiding significance for guiding the diagnosis of thrombotic disease in clinical practice,initiating anticoagulation,and strengthening anticoagulant treatment.
关键词
高龄老年/D-二聚体/血栓性疾病/抗凝治疗Key words
Advanced age/D-dimer/Thrombotic diseases/Anticoagulation therapy引用本文复制引用
基金项目
吴阶平医学基金会(320.6750.18456)
出版年
2024
NETL
NSTL
万方数据