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目的:探讨D-二聚体对急性主动脉夹层(AD)患者在院期间死亡的预测价值。方法:收集2013年1月—2015年12月收治的83例AD患者资料,根据患者在院期间是否死亡分为生存组(62例)和死亡组(21例),比较两组D-二聚体水平及其他相关临床因素,采用回归分析探讨患者死亡的危险因素。结果:两组年龄、性别、吸烟、高血压、糖尿病等因素差异无统计学意义(均P>0.05),但死亡组患者比例的A型病变和D-二聚体水平明显高于生存组(均P<0.05)。Logistic回归分析显示,A型病变(OR=0.117,95%CI=0.021~0.792)与D-二聚体(OR=3.180,95%CI=1.551~5.984)是患者死亡的风险因素(均P<0.05)。D-二聚体水平预测患者死亡的受试者工作特征曲线下面积为0.819(95%CI=0.807~0.974,P<0.001),最佳临界点为4.85μg/m L,敏感度和特异性分别为85.7%和75.8%。结论:D-二聚体作为一个快速检测指标,可以对AD患者进行简便危险评估,对于D-二聚体较高的患者,应对进行积极干预。
Objective: To investigate the predictive value of D-dimer in the death of acute aortic dissection (AD) during hospitalization. Methods: Data of 83 patients with AD were collected from January 2013 to December 2015. The patients were divided into survival group (62 cases) and death group (21 cases) according to whether they died during the hospitalization. Body level and other related clinical factors, using regression analysis to explore the risk factors for death in patients. Results: There was no significant difference in age, sex, smoking, hypertension, diabetes and other factors between the two groups (all P> 0.05). However, the proportion of type A lesions and D-dimer in the death group was significantly higher than that in the survival group All P <0.05). Logistic regression analysis showed that the risk factors of death were type A (OR = 0.117, 95% CI = 0.021-0.792) and D-dimer (OR = 3.180, 95% CI 1.551-5.984) 0.05). The area under the working characteristic curve of subjects who predicted the death of D-dimer was 0.819 (95% CI = 0.807-0.974, P <0.001). The best cut-point was 4.85μg / m L and the sensitivity and specificity Respectively 85.7% and 75.8%. CONCLUSIONS: D-dimer, as a rapid measure of risk, can be used to assess simple risk in patients with AD and respond positively to intervention in patients with high D-dimer.