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目的探讨血浆D-二聚体在肝硬化食管静脉曲张及其氩离子凝固术治疗患者中的变化。方法运用ELISA双抗体夹心法分别对发生食管静脉曲张(B组)和未发生食管静脉曲张(A组)的肝硬化患者,以及应用氩气刀行内镜下氩离子凝固术序贯治疗出现上消化道出血的肝硬化患者(C组)的血浆D-二聚体进行测定。结果 A、B、C3组肝硬化患者血浆D-二聚体浓度[(385±1.7)mg/L、(515±1.8)mg/L、(801±1.5)mg/L]较正常参考值均升高(P均<0.05),且发生上消化道出血者(C组)高于有或无食管静脉曲张者(B、A组)(P均<0.05),有食管静脉曲张者高于无食管静脉者但差异无统计学意义(P>0.05);氩离子凝固术序贯治疗后肝硬化患者的血浆D-二聚体浓度[(1209±1.2)mg/L〗较本组治疗前明显升高(P均<0.05),但术后1个月明显下降[(582±1.1)mg/L],接近未发生过上消化道出血的肝硬化2组患者的血浆D-二聚体浓度(P>0.05)。结论血浆D-二聚体测定对预测食管静脉曲张出血有一定意义,其水平的动态变化可用于氩气刀凝固术效果的评估。
Objective To investigate the changes of plasma D-dimer in patients with cirrhosis esophageal varices and argon plasma coagulation. Methods The double antibody sandwich ELISA method was applied to patients with cirrhosis who had esophageal varices (group B) and esophageal varices (group A), and argon plasma coagulation with argon knife Plasma D-dimer was measured in patients with cirrhosis of the gastrointestinal tract (Group C). Results Plasma D-dimer levels in patients with liver cirrhosis were (385 ± 1.7) mg / L, (515 ± 1.8) mg / L, (801 ± 1.5) mg / L] (All P <0.05), and those with upper gastrointestinal bleeding (group C) were higher than those with or without esophageal varices (group B and A) (all P <0.05), those with esophageal varices were higher than those without esophageal varices (P> 0.05). The plasma D-dimer concentration in patients with cirrhosis [(1209 ± 1.2) mg / L after sequential argon plasma coagulation was significantly higher than that before treatment in this group (P <0.05), but decreased significantly at 1 month after operation ([(582 ± 1.1) mg / L], which was close to the plasma D-dimer concentration in two groups of cirrhotic patients without upper gastrointestinal bleeding (P> 0.05). Conclusion The determination of plasma D-dimer has some significance in the prediction of esophageal variceal bleeding. The dynamic changes of plasma D-dimer can be used to evaluate the effect of Argon coagulation.