D-dimer

摘要： 目的:分析探讨急性脑梗塞患者中医证候积分与血D-Dimer、hs-CRP、Hcy水平及脑电图检查结果的关系。方法:收集急性脑梗塞患者161例为试验组,依据中医证候积分情况分为轻型组48例、中型组91例、重型组22例;另选60例健康人作为对照组。比较各组血D-Dimer、 hs-CRP、Hcy水平及脑电图检查结果的不同。结果:对照组血D-Dimer、hs-CRP、Hcy水平均正常,试验组治疗前血D-Dimer、hs-CRP、Hcy水平均明显升高。治疗28天后,试验组血D-Dimer、hs-CRP、Hcy水平均较治疗前明显下降,但高于对照组(P<0.05)。轻型、中型、重型三组血D-Dimer、hs-CRP、Hcy水平依次升高(P<0.05),脑电图异常阳性率依次升高(P<0.05)。结论:随着急性脑梗塞患者中医证候积分增加,血D-Dimer、hs-CRP、Hcy水平相对升高,脑电图异常阳性率相对升高,脑电图异常程度相应更重。

摘要： BACKGROUND Von-Willebrand factor(vWF)disposes certain prognostic value in patients with liver cirrhosis,but its relation to other prognostic indicators has not been fully investigated.AIM To analyze the relation between vWF and other prognostic indicators in cirrhotic patients and to evaluate its prognostic value for mortality.METHODS This analytic prospective study was carried out in a tertiary center and initially enrolled 71 patients with liver cirrhosis and portal hypertension.It analyzed the relation between vWF and the stage of the disease and several inflammatory and prognostic indicators.The prospective analysis,performed on a sample of 63 patients,evaluated the association between the selected variables[vWF,Model for End-stage Liver Disease(MELD)score,C-reactive protein(CRP),ferritin,vitamin D,activated partial thromboplastin time,thrombin time,D-dimer concentration]and the survival time as well as their predictive value in terms of 3-mo,6-mo and 1-year mortality.RESULTS vWF was significantly higher in patients with higher Child-Turcotte-Pugh class(P=0.0045),MELD group(P=0.0057),ferritin group(P=0.0278),and D-dimer concentration(P=0.0232).vWF significantly correlated with D-dimer concentration,ferritin,CRP,International Normalized Ratio,and MELD,Child-Turcotte-Pugh,Sequential Organ Failure Assessment,and CLIF-consortium organ failure(CLIF-C OF)scores.vWF,MELD score,and CRP were significantly associated with death and were significant predictors of 3-mo,6-mo,and 1-year mortality.Each vWF unit significantly increased the probability for 3-mo mortality by 1.005 times(P=0.008),for 6-mo mortality by 1.006 times(P=0.005),and for 1-year mortality by 1.007 times(P=0.002).There was no significant difference between the diagnostic performance of vWF and MELD score and also between vWF and CRP regarding the 3-mo,6-mo,and 1-year mortality.CONCLUSION In patients with liver cirrhosis,vWF is significantly related to other prognostic indicators and is a significant predictor of 3-mo,6-mo,and 1-year mortality similar to MELD score and CRP.

摘要： BACKGROUND Neonatal sepsis is a life-threatening disease.Early diagnosis is essential,but no single marker of infection has been identified.Sepsis activates a coagulation cascade with simultaneous production of the D-dimers due to lysis of fibrin.Ddimer test reflects the activation of the coagulation system.AIM To assess the D-dimer plasma level,elaborating its clinicopathological value in neonates with early-onset and late-onset neonatal sepsis.METHODS The study was a prospective cross-sectional study that included ninety neonates;divided into three groups:Group I:Early-onset sepsis(EOS);Group II:Late-onset sepsis(LOS);and GroupⅢ:Control group.We diagnosed neonatal sepsis according to our protocol.C-reactive protein(CRP)and D-dimer assays were compared between EOS and LOS and correlated to the causative microbiological agents.RESULTS D-dimer was significantly higher in septic groups with a considerably higher number of cases with positive D-dimer.Neonates with LOS had substantially higher levels of D-dimer than EOS,with no significant differences in CRP.Neonates with LOS had a significantly longer hospitalization duration and higher gram-negative bacteriemia and mortality rates than EOS(P<0.01).Gramnegative bacteria have the highest D-dimer levels(Acinetobacter,Klebsiella,and Pseudomonas)and CRP(Serratia,Klebsiella,and Pseudomonas);while gram-positive sepsis was associated with relatively lower levels.D-dimer had a significant negative correlation with hemoglobin level and platelet count;and a significant positive correlation with CRP,hospitalization duration,and mortality rates.The best-suggested cut-off point for D-dimer in neonatal sepsis was 0.75 mg/L,giving a sensitivity of 72.7%and specificity of 86.7%.The D-dimer assay has specificity and sensitivity comparable to CRP in the current study.CONCLUSION The current study revealed a significant diagnostic value for D-dimer in neonatal sepsis.D-dimer can be used as an adjunct to other sepsis markers to increase the sensitivity and specificity of diagnosing neonatal sepsis.

摘要： In this study,our aim was to examine the diagnostic and prognostic significance of lymphocyte/C-reactiveprotein ratio(LCR),neutrophil/lymphocyte ratio(NLR)and D-dimer parameters in COVID-19 infection.The LCR,NLR,neutrophil count,mean platelet volume(MPV),C-reactive protein(CRP),and D-dimer parameters wereevaluated retrospectively.This was a retrospective cohort study with 1000 COVID-19 positive and 1000 healthycontrol groups,all over the age of 18 years.Odds ratio(OR)and 95%confidence interval(CI)values were calculatedfor each parameter found to be statistically significant in the univariate and multivariate logistic regression models.Herein,127(12.7%)of the COVID-19^(+)patients,whose data was included in this study,died.The neutrophil,MPV,CRP,D-dimer,and NLR values were higher in the COVID-19^(+)/deceased group than in the COVID-19^(+)/alive andcontrol groups(p<0.001,p<0.001,p<0.001,p<0.001,p<0.001).The lymphocyte and LCR values were lower inthe COVID-19^(+)/deceased group than in the COVID-19^(+)/alive and control groups(p<0.001,p<0.001).Variableswith statistically significance in predicting COVID-19 infection were lymphocyte,LCR,D-dimer,NLR,CRP,MPV,PLT,and neutrophil values.Statistically significant variables in predicting mortality due to COVID-19 were LCR,CRP,NLR,lymphocyte,D-dimer,neutrophil,and MPV values.A low LCR and high NLR are associated with thepresence,prognosis,and mortality due to COVID-19.LCR and NLR parameters can thus be used in clinicalmonitoring to reduce morbidity and mortality rates.

摘要： BACKGROUND Coronavirus disease 2019(COVID-19) has been far more devastating than expected, showing no signs of slowing down at present. Heilongjiang Province is the most northeastern province of China, and has cold weather for nearly half a year and an annual temperature difference of more than 60°C, which increases the underlying morbidity associated with pulmonary diseases, and thus leads to lung dysfunction. The demographic features and laboratory parameters of COVID-19 deceased patients in Heilongjiang Province, China with such climatic characteristics are still not clearly illustrated.AIM To illustrate the demographic features and laboratory parameters of COVID-19 deceased patients in Heilongjiang Province by comparing with those of surviving severe and critically ill cases.METHODS COVID-19 deceased patients from different hospitals in Heilongjiang Province were included in this retrospective study and compared their characteristics with those of surviving severe and critically ill cases in the COVID-19 treatment center of the First Affiliated Hospital of Harbin Medical University. The surviving patients were divided into severe group and critically ill group according to the Diagnosis and Treatment of New Coronavirus Pneumonia(the seventh edition).Demographic data were collected and recorded upon admission. Laboratory parameters were obtained from the medical records, and then compared among the groups.RESULTS Twelve COVID-19 deceased patients, 27 severe cases and 26 critically ill cases were enrolled in this retrospective study. No differences in age, gender, and number of comorbidities between groups were found. Neutrophil percentage(NEUT%), platelet(PLT), C-reactive protein(CRP), creatine kinase isoenzyme(CK-MB), serum troponin I(TNI) and brain natriuretic peptides(BNP) showed significant differences among the groups(P = 0.020, P = 0.001, P < 0.001, P = 0.001, P < 0.001, P <0.001, respectively). The increase of CRP, D-dimer and NEUT% levels, as well as the decrease of lymphocyte count(LYMPH) and PLT counts, showed significant correlation with death of COVID-19 patients(P = 0.023, P = 0.008, P = 0.045, P = 0.020, P = 0.015, respectively).CONCLUSION Compared with surviving severe and critically ill cases, no special demographic features of COVID-19 deceased patients were observed, while some laboratory parameters including NEUT%, PLT, CRP, CK-MB, TNI and BNP showed significant differences. COVID-19 deceased patients had higher CRP, D-dimer and NEUT% levels and lower LYMPH and PLT counts.

摘要： Introduction: Pulmonary symptoms of COVID-19 infection range from asymptomatic infection to severe pneumonia. Pathogenesis and severity of symptoms were found to be related to the body’s immune response. Objectives: Ferritin and D-Dimer in COVID-19 confirmed cases can predict lung injury and possible poor patient prognosis. Materials and Methods: Patients who had been admitted to Dr. Sulaiman Alhabib-Arryan Hospital with positive COVID-19 polymerase chain reaction (PCR) tests between March 2020 and December 2021 were studied for blood ferritin and D-Dimer levels in relation to pulmonary radiological findings. Results: A total of 494 cases are included in this study. Male patients represent 74.1% of the cases, and the mean age is 51.68 ± 13.37 years. Increased age, ferritin, D-Dimer levels, and respiratory symptoms are factors that showed a statistically significant association with positive computed tomography (CT) findings. Receiver operator characteristic curve (ROC) showed that ferritin has a higher capability than D-Dimer to detect CT findings and that both are equal in predicting possible patient mortality. Suggested cutoff values for Ferritin > 336 ng/mL, with 78.21% sensitivity and 86.42% specificity and for D-Dimer > 0.55 mg/L FEU, with sensitivity of 74.82% and specificity of 75.31%. For mortality, the suggested cutoff point for ferritin is >864.6 ng/mL, which gives a sensitivity of 80.26 and a specificity of 64.83%. The suggested cutoff point for D-Dimer is >1.46 mg/L FEU, which gives a sensitivity of 65.79% and a specificity of 78.23%. Conclusion: Laboratory markers such as Ferritin and D-Dimer can be an accurate predictor of lung injury in COVID-19 patients and their increased values can predict the poor patient prognosis and possible mortality if aggressive hospital care is not provided.

摘要： Background: Pregnant women and newborns are highly susceptible to Covid-19, manifesting as multisystem inflammatory syndrome-New-born (MISC-N) in many babies born to Covid positive mothers. The relationship between Covid-19 infection during pregnancy and neonatal neurodevelopmental outcome, if any, is unclear necessitating a follow-up study in this aspect. Methods: 16 babies with MIS-N, born to symptomatic Covid antibody positive mothers were enrolled. Demographic profile, treatment details and biochemical parameters were analyzed with neurodevelopmental follow-up. Results: 25% mothers received 2 doses of Covid vaccine;50% had oligohydramnios and 75% received antenatal steroids. 87.5% were preterm of which 62.5% required surfactant with ventilator support and 75% required ionotropic support. Significant association was found between the antibody level and D-dimer levels with the ferritin and LDH levels of the baby (p 0.05);gestational age with LDH and D-dimer levels (p 0.05) and Covid antibody level of the baby vs the duration of ventilator requirement (P-value-0.0009). D-dimer values of babies were positively associated with both maternal antibody and D-dimer levels. Neurodevelopmental follow-up done at 6 months of corrected gestational age showed 37.5% were normal, 37.5% hypertonic and 25% hypotonic. HINE score was below 60 in 62.5%. Development assessment using Bayley-III showed a delay in the motor domain (62.5%), cognitive domain (56.25%) and language domain (62.5%). Conclusion: Neurodevelopmental problems occur in babies born to Covid positive mothers and should be stratified as “high risk”. Anticipatory guidance to prospective mothers for preterm care should be given. Covid antibody titre and D-dimer levels may help to predict the NICU stay, ventilator requirement and the adverse neurodevelopmental outcomes in these babies.

摘要： BACKGROUND Acute pancreatitis(AP)is a common critical disease of the digestive system that is often associated with multiple complications.Vascular complications are relatively rare and are one of the causes of death.AP complicated with pulmonary embolism(PE)is even rarer,and there are no reports of AP complicated with PE in elderly patients.CASE SUMMARY We describe a rare case of AP complicated with PE and review the literature.A 68-year-old woman was diagnosed with AP due to widespread abdominal pain.During the course of treatment,the patient had shortness of breath and progressively worsening dyspnea without chest pain or hemoptysis with a progressive increase in D-dimer and fibrin degradation product.Respiratory failure and right heart failure occurred,and refractory hypoxemia remained after mechanical ventilation.Plain chest computed tomography revealed a small amount of left pleural effusion and external pressure atelectasis in the lower lobe of the left lung but no findings that could lead to refractory hypoxemia.Color Doppler ultrasound indicated pulmonary hypertension and extensive venous thrombosis in the lower extremities.Chest computed tomography angiography finally suggested pulmonary thromboembolism.The patient’s dyspnea symptoms disappeared after anticoagulation treatment.CONCLUSION During the diagnosis and treatment of AP,it is necessary to dynamically monitor D-dimer and consider PE.

摘要： 目的:探讨PCT、hs-CRP、D-Dimer及PLT在评估肾综合征出血热患者病情中的临床意义.方法:选取符合我院入组条件病例数共60例肾综合征出血热患者为观察组,另选取同时期60例健康体检者为对照组,对比两组研究资料以及观察组组内患者PCT、hs-CRP、D-Dimer及PLT水平.结果:两组研究资料PCT、hs-CRP、D-Dimer及PLT水平存在明显差异,有统计学意义(P0.05).结论:PCT能够对肾综合征出血热患者是否出现细菌感染进行诊断鉴别,hs-CRP、D-Dimer及PLT能够作为患者病情变化评估的重要指标.

摘要： 目的:探讨血浆D-二聚体(D-Dimer)和可溶性细胞间黏附分子-1(sICAM-1)水平在诊治急性胰腺炎(AP)患者时的临床意义.方法:将本院2017年7月—2019年9月收治的90例AP患者纳入研究样本,依据病情严重程度分为重症急性胰腺炎(SAP)组(n=42)和轻症急性胰腺炎(MAP)组(n=48),并选取同期本院健康体检者45例作为正常对照组,比较三组的血浆D-Dimer和sICAM-1水平,入组患者均行急性胰腺炎Ranson评分系统和急性生理与慢性健康评估系统(APACHEⅡ)评估,并将两种血浆指标与两种病情程度评估系统结果进行相关性分析.结果:SAP组患者的血浆D-Dimer、sICAM-1水平均显著高于MAP组和正常对照组(P<0.05),且MAP组显著高于正常对照组(P<0.05);SAP组患者的Ranson评分及APACHEⅡ评分均显著高于MAP组(P<0.05);SAP组和MAP组患者的Ran-son评分及APACHEⅡ评分与血浆D-Dimer、sICAM-1水平均呈显著正相关.结论:血浆D-Dimer和sICAM-1的表达水平在AP患者的诊治中有重要参考价值,当其水平越高则提示患者病情越重.

摘要： 下肢深静脉血栓形成(DVT)是周围血管病中常见的疾病，其发病率较高，危害性大，可引起肺栓塞、静脉功能不全等，特别是血管内皮和瓣膜的破坏后留下后遗症，临床上治疗困难，没有针对性的药物，本研究应用中药自制制剂维尔迈治疗DVT后遗症患者取得较好效果，为证实该药物的机理，经动物实验证明其对大鼠静脉损伤模型的内皮相关指标组织型纤溶酶原活化剂(t-PA)、纤溶酶原激活剂抑制因子-1(PAI-1)和D二聚体活性有明显的影响，从而为临床应用提供依据。

摘要： 下肢深静脉血栓形成(DVT)是周围血管病中常见的疾病，其发病率较高，危害性大，可引起肺栓塞、静脉功能不全等，特别是血管内皮和瓣膜的破坏后留下后遗症，临床上治疗困难，没有针对性的药物，本研究应用中药自制制剂维尔迈治疗DVT后遗症患者取得较好效果，为证实该药物的机理，经动物实验证明其对大鼠静脉损伤模型的内皮相关指标组织型纤溶酶原活化剂(t-PA)、纤溶酶原激活剂抑制因子-1(PAI-1)和D二聚体活性有明显的影响，从而为临床应用提供依据。

摘要： 下肢深静脉血栓形成(DVT)是周围血管病中常见的疾病，其发病率较高，危害性大，可引起肺栓塞、静脉功能不全等，特别是血管内皮和瓣膜的破坏后留下后遗症，临床上治疗困难，没有针对性的药物，本研究应用中药自制制剂维尔迈治疗DVT后遗症患者取得较好效果，为证实该药物的机理，经动物实验证明其对大鼠静脉损伤模型的内皮相关指标组织型纤溶酶原活化剂(t-PA)、纤溶酶原激活剂抑制因子-1(PAI-1)和D二聚体活性有明显的影响，从而为临床应用提供依据。

摘要： 下肢深静脉血栓形成(DVT)是周围血管病中常见的疾病，其发病率较高，危害性大，可引起肺栓塞、静脉功能不全等，特别是血管内皮和瓣膜的破坏后留下后遗症，临床上治疗困难，没有针对性的药物，本研究应用中药自制制剂维尔迈治疗DVT后遗症患者取得较好效果，为证实该药物的机理，经动物实验证明其对大鼠静脉损伤模型的内皮相关指标组织型纤溶酶原活化剂(t-PA)、纤溶酶原激活剂抑制因子-1(PAI-1)和D二聚体活性有明显的影响，从而为临床应用提供依据。

摘要： 下肢深静脉血栓形成(DVT)是周围血管病中常见的疾病，其发病率较高，危害性大，可引起肺栓塞、静脉功能不全等，特别是血管内皮和瓣膜的破坏后留下后遗症，临床上治疗困难，没有针对性的药物，本研究应用中药自制制剂维尔迈治疗DVT后遗症患者取得较好效果，为证实该药物的机理，经动物实验证明其对大鼠静脉损伤模型的内皮相关指标组织型纤溶酶原活化剂(t-PA)、纤溶酶原激活剂抑制因子-1(PAI-1)和D二聚体活性有明显的影响，从而为临床应用提供依据。

摘要： 下肢深静脉血栓形成(DVT)是周围血管病中常见的疾病，其发病率较高，危害性大，可引起肺栓塞、静脉功能不全等，特别是血管内皮和瓣膜的破坏后留下后遗症，临床上治疗困难，没有针对性的药物，本研究应用中药自制制剂维尔迈治疗DVT后遗症患者取得较好效果，为证实该药物的机理，经动物实验证明其对大鼠静脉损伤模型的内皮相关指标组织型纤溶酶原活化剂(t-PA)、纤溶酶原激活剂抑制因子-1(PAI-1)和D二聚体活性有明显的影响，从而为临床应用提供依据。