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目的探讨红细胞分布宽度(red blood cell distribution width,RDW)、尿酸(uric acid,UA)及D-二聚体对肺栓塞患者病情判断及预后的临床意义。方法收集2010年6月—2012年10月本院住院的62例肺栓塞患者的临床资料,其中男20例,女42例,最新欧洲心脏病协会急性肺栓塞诊断和管理指南[1]中根据有关危险分层,将入选患者分为3组:(1)高危肺栓塞组(A组,11例);(2)中危肺栓塞组(B组,16例);(3)低危肺栓塞组(C组,35例)。抽取患者入院时外周静脉血,检测PD、UA及D-二聚体,并记录其结果。计量资料采用t检验,P<0.05为差异有统计学意义。结果高、中、低危肺栓塞三组患者RDW数值为(15.53±2.18)%、(13.74±1.05)%、(13.35±0.91)%,UA数值(375.67±133.26)、(357.45±106.35)、(273.95±77.8)μmol/L。由此得出A组及B组中的RDW、UA水平均较C组的水平明显升高,A组中的RDW、UA的水平也高于B组,各组之间相比差异均有统计学意义(均P<0.05)。与正常参考值相比较,三组中D-二聚体的含量均明显升高,但各组间差异无统计学意义(P>0.05)。结论肺栓塞患者中,RDW、UA水平越高,患者的危险分层越高,病情越重,死亡率增高;对于临床急性肺栓塞患者RDW、UA及D-二聚体常用的化验指标可指导医生对该病的病情判断及预后评估。
Objective To investigate the clinical significance of red blood cell distribution width (RDW), uric acid (UA) and D-dimer in judging the prognosis of patients with pulmonary embolism. Methods The clinical data of 62 patients with pulmonary embolism who were admitted to our hospital from June 2010 to October 2012 were collected, including 20 males and 42 females. The latest European Association of Cardiology guidelines for the diagnosis and management of acute pulmonary embolism [1] For the risk stratification, the patients were divided into three groups: (1) high-risk pulmonary embolism group (group A, 11 cases); (2) moderate-risk pulmonary embolism group (group B, 16 cases); Embolization group (C group, 35 cases). Peripheral venous blood was collected from patients on admission to detect PD, UA and D-dimer, and the results were recorded. Measurement data using t test, P <0.05 for the difference was statistically significant. Results The RDW values were (15.53 ± 2.18)%, (13.74 ± 1.05)%, (13.35 ± 0.91)%, UA (375.67 ± 133.26), (357.45 ± 106.35), (273.95 ± 77.8) μmol / L. The results showed that the levels of RDW and UA in group A and group B were significantly higher than those in group C, and the levels of RDW and UA in group A were also higher than those in group B. The differences among groups were statistically significant Significance (both P <0.05). Compared with the normal reference value, the contents of D-dimer in three groups were significantly increased, but there was no significant difference among the three groups (P> 0.05). Conclusions In patients with pulmonary embolism, the higher the RDW and UA levels, the higher the risk stratification, the more severe the disease and the higher the mortality rate. The laboratory tests commonly used on RDW, UA and D-dimer in patients with acute pulmonary embolism may guide The doctor’s judgment of the disease and prognosis.