D-Dimer in Acute Pancreatitis A New Approach for an Early Assessment of Organ Failure
D-Dimer in Acute Pancreatitis A New Approach for an Early Assessment of Organ Failure
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DOI：
10.1097/mpa.0b013e3181a66860
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发表时间：
2009-08-01
期刊：
影响因子：
2.9
通讯作者：
Gregoric, Pavle
中科院分区：
文献类型：
--
作者：
Radenkovic, Dejan;Bajec, Djordje;Gregoric, Pavle
目的：止血参数对预测胰腺炎相关并发症的临床价值的研究尚不多见。这项前瞻性研究的目的是找出有用的止血标志物，以准确地确定急性胰腺炎(AP)早期器官衰竭(OF)的后续发展。方法：对91例首次入院的AP患者在入院24小时内和24小时后测定血浆凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、抗凝血酶III、蛋白C、纤溶酶原激活物抑制物1、D-二聚体和纤溶酶原。结果：干预组与非干预组入院时凝血酶原时间、纤维蛋白原、D-二聚体水平有显著差异，入院后24小时这些指标加抗凝血酶III均有显著差异。入院时D-二聚体浓度以414.00微克/L为临界值是预测AP发生的最佳界值，其敏感性、特异性、阳性预测值和阴性预测值分别为90%、89%、75%和96%。结论：入院时测定血浆D-二聚体水平是判断AP患者病情进展的准确方法。
Objectives: Studies on the clinical value of parameters of hemostasis in predicting pancreatitis-associated complications are still scarce. The aim of this prospective study was to identify the useful hemostatic markers for accurate determination of the subsequent development of organ failure (OF) during the very early course of acute pancreatitis (AP).Methods: In 91 consecutive primarily admitted patients with AP, prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin III, protein C, plasminogen activator inhibitor 1, D-dimer, and plasminogen were measured in plasma within the first 24 hours of admission and 24 hours thereafter. Two study groups comprising 24 patients with OF and 67 patients without OF were compared.Results: Levels of prothrombin time, fibrinogen, and D-dimer on admission were significantly different between the OF and non-OF groups, and all these parameters plus antithrombin III were significantly different 24 hours later. A D-dimer value of 414.00 mu g/L on admission was the best cutoff value in predicting the development of OF with sensitivity, specificity, and positive and negative predictive values of 90%, 89%, 75%, and 96%, respectively.Conclusions: Measurement of plasma levels of D-dimer on the admission is an accurate method for the identification of patients who will develop OF in the further course of AP.