【摘要】 目的 :探讨不同程度颅内进展性出血性损伤患者D-二聚体的表达水平和意义。方法 :将我院自2012年7月～2016年6月间收治的60例颅内进展性出血性损伤患者作为研究组,收集患者临床资料,根据格拉斯哥昏迷评分(GCS)将患者分为重度、中度和轻度亚组,根据格拉斯哥预后评分(GOS)分为优秀、良好和不良亚组,同时选择同期入院体检的20名健康人员作为对照组,测定患者血浆中D-二聚体水平,比较格拉斯哥评分下D-二聚体水平的变化,并统计分析其水平患者发病原因和格拉斯哥评分之间的关系。结果 :所有患者根据GCS分为重度14例,中度31例,轻度15例;根据GOS分为优秀16例,良好32例,不良12例,未出现死亡病例。研究组患者D-D水平均明显高于对照组,差异具有统计学意义;GCS评分后重度患者的D-D水平显著高于中度组、轻度组,中度组患者的D-D水平显著高于轻度组患者;GOS评分后不良组D-D水平显著高于良好组、优秀组,良好组D-D水平显著高于优秀组;Spearman分析结果显示,D-D水平和GCS和GOS呈负相关。结论 :早期检测血浆中D-D水平可有效的反应颅内进展性出血性损伤患者的病情和预后水平,可帮助临床医师做出准确的诊断,实施相应的治疗方案,以提高患者的治疗和预后。更多还原

【Abstract】 Objective The expression and significance of D-dimer are investigated in patients with progressive intracranial hemorrhagic injury of varying degree. Methods In our hospital from July 2012 to June 2016 a total of 60 cases of intracranial progressive hemorrhagic injury patients as the study group, the clinical data were collected, according to Glasgow coma scores(GCS) were divided into severe, moderate and mild groups, according to the Glasgow outcome score(GOS) divided into excellent, good and poor groups, while 20 healthy people the same hospital were selected as control group, detecting plasma D-dimer level, comparing change of D-dimer level under Glasgow score, and performing statistical analysis of the relationship between the level of patients with pathogenesis and Glasgow score. Results All patients were divided into severe 14 cases, moderate 31 cases and mild 15 cases according to GCS, and divided into excellent 16 cases, good 32 cases and poor 12 cases according to GOS, death case had not been reported. D-dimer level in study group was dramatically higher that in control group. The GCS score in patients with severe D-dimer level was the highest, followed by moderate, mild lowest, the difference was statistically significant; the GOS score of D-dimer after treatment was the highest, followed by good, poor is lowest, the difference was statistically significant. The results of Spearman analysis showed that a negative D-dimer with GCS and GOS. Conclusion Early detection of plasma levels of D-dimer can be effective to reflect severity and prognosis of patients with intracranial progressive hemorrhagic injury, which may help clinicians to make accurate diagnosis and implement corresponding treatment plan in order to improve the treatment and prognosis of patients.更多还原