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目的研究单纯肺结核(PTB)及其合并其他不同肺部疾病住院患者血浆D-二聚体(D-D)和纤维蛋白原(FIB)水平,探讨其临床意义。方法以2016年1-6月研究期间住院PTB患者为对象,检测分析单纯PTB患者、PTB合并肺炎、PTB合并结核性胸膜炎、PTB合并慢性阻塞性肺疾病(COPD)患者和40例健康对照者的血浆D-D和FIB水平的差异。结果分别有75例单纯PTB患者、57例PTB合并肺炎、38例PTB合并结核性胸膜炎、30例PTB合并慢性阻塞性肺疾病(COPD)患者和40例健康对照者纳入分析。各研究组的血浆D-D和FIB水平差异均有统计学意义(血浆D-D:H=57.118,P=0.000。血浆FIB:F=13.986,P=0.001)。血浆中D-D水平取大于0.5 mg/L为阳性,其中D-D水平阳性率以PTB合并结核性胸膜炎组最高(65.79%),PTB合并COPD次之(59.67%),PTB合并肺炎组为56.67%,单纯PTB为44%,健康对照未检出阳性;血浆中FIB水平取大于4 g/L为阳性,FIB水平阳性率以PTB合并肺炎组阳性率最高(54.39%),PTB合并结核性胸膜炎次之(47.37%),PTB合并COPD组为33.33%,单纯PTB为30.67%,健康对照检出阳性1例。结论单纯PTB及其合并结核性胸膜炎、合并肺炎、合并慢性阻塞性肺疾病(COPD)住院患者,其血浆D-D和FIB水平升高。监测结核病患者及其合并不同肺部疾患的血浆D-D和FIB水平,对预防血栓并发症有重要临床意义。
Objective To study the plasma levels of D-D and fibrinogen (FIB) in patients with simple pulmonary tuberculosis (PTB) and other pulmonary diseases combined with other diseases, and to explore its clinical significance. Methods In-hospital PTB patients during the study period from January to June 2016 were enrolled in this study. The clinical data of patients with PTB, PTB combined with pneumonia, PTB combined with tuberculous pleuritis, PTB with chronic obstructive pulmonary disease (COPD) and 40 healthy controls Differences in plasma DD and FIB levels. RESULTS: Seventy-five patients with PTB, 57 PTB complicated with pneumonia, 38 PTB with tuberculous pleurisy, 30 PTB with COPD and 40 healthy controls were included in the analysis. Plasma D-D and FIB levels were significantly different in all study groups (plasma D-D: H = 57.118, P = 0.000; plasma FIB: F = 13.986, P = 0.001). The positive rate of DD in patients with PTB combined with tuberculous pleurisy was the highest (65.79%), PTB with COPD was the second (59.67%), PTB combined with pneumonia was 56.67% PTB was 44%, positive control did not detect positive; plasma FIB levels greater than 4 g / L was positive, the positive rate of FIB in PTB combined pneumonia group the highest positive rate (54.39%), PTB combined with tuberculous pleurisy second ( 47.37%). The PTB combined with COPD group was 33.33%, the pure PTB was 30.67%, and the positive control group was positive in 1 case. Conclusions The plasma levels of D-D and FIB in pure PTB and tuberculous pleurisy combined with pneumonia and inpatients with chronic obstructive pulmonary disease (COPD) are elevated. Monitoring the plasma levels of D-D and FIB in patients with tuberculosis and their combination with different lung conditions is of great clinical importance in the prevention of thromboembolic complications.