目的 观察血浆D-二聚体水平在急性缺血性结肠炎发病过程中的变化,探讨其在急性缺血性结肠炎早期诊断中的价值.方法 采用微粒子酶免分析法检测36例急性缺血性结肠炎(观察组)患者入院第1、7、14天血浆D-二聚体水平,并与34例健康体检者(对照组)比较;分析D-二聚体水平与急性缺血性结肠炎病变范围的关系.结果 入院第1天及治疗第7、14天,观察组患者血浆D-二聚体水平均显著高于对照组,差异有统计学意义(P＜0.01).观察组中,全结肠病变患者血浆D-二聚体水平显著高于乙状结肠、降结肠、横结肠、升结肠病变患者,降结肠及乙状结肠病变患者血浆D-二聚体水平亦显著高于乙状结肠、降结肠、横结肠、升结肠病变患者,差异均有统计学意义(P＜0.05).结论 急性缺血性结肠炎患者血浆D-二聚体水平较健康者显著升高,故通过检测血浆D-二聚体水平可以早期诊断急性缺血性结肠炎;病变范围广患者的血浆D-二聚体水平显著高于病变范围小患者.%Objective To explore the fluctuation of plasma D - dimer and its clinical significance in acute ischemic colitis. Methods Plasma levels of D - dimer were measured using micro particle enzyme immunoassay in 36 patients with acute ischemic colitis ( on day 1, 7 and 14 after admission ) and compared with those in 34 healthy controls. Correlations between plasma D - dimer and ischemic area were analyzed. Results Levels of plasma D - dimer were much higher in the ischemic colitis group than in the control group on day 1, 7 and 14 after admission ( P <0. 01 ). Within the ischemic colitis group, plasma D - dimer levels were much higher in patients with pancolonic lesions than in those with lesions in the sigmoid colon, the descending colon, the tansverse colon, and the ascending colon and higher in patients with lesions in the sigmoid colon and the descending colon than in those with lesions in the sigmoid colon, the descending colon, the tansverse colon, and the ascending colon ( P <0. 05 ). Conclusion The level of plasma D - dimer can aid the early diagnosis of acute ischemic colitis and the assessment of lesion size.
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