PLASMA D-DIMER LEVELS AND THEIR RELATIONSHIP TO SERUM FIBRINOGEN FIBRIN DEGRADATION PRODUCTS IN HYPERCOAGULABLE STATES
PLASMA D-DIMER LEVELS AND THEIR RELATIONSHIP TO SERUM FIBRINOGEN FIBRIN DEGRADATION PRODUCTS IN HYPERCOAGULABLE STATES
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DOI：
10.1111/j.1365-2141.1989.tb06276.x
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发表时间：
1989-01-01
影响因子：
6.5
通讯作者：
PRESTON, FE
中科院分区：
文献类型：
--
作者：
WILDE, JT;KITCHEN, S;PRESTON, FE
测定弥散性血管内凝血（DIC）和其他高凝状态相关疾病患者血浆D-二聚体，并与血清纤维蛋白原/纤维蛋白降解产物（FDP）水平进行比较。D-dimer（N < 200 ng/ml）在所有43例DIC患者中升高，在59例肝病患者中48例升高，在27例急性白血病患者中22例升高，在23例恶性疾病患者中17例升高，在29例妊娠晚期妇女中升高，18例深静脉血栓形成患者中有17例发生血栓，27例急性心肌梗死患者中仅4例发生血栓。血浆D-二聚体与血清FDP水平呈显著正相关（P < 0.01）：DIC：r = 0.58，肝病：r = 0.57，急性白血病：r = 0.84，恶性肿瘤：r = 0.87。在肝病、急性白血病、恶性肿瘤和妊娠并发症中观察到的D-二聚体频繁升高表明，高凝状态在这些疾病中是常见的，尽管在肝病中不能排除正常清除机制失败导致的水平升高。D-二聚体和FDP水平之间的密切关系表明，血清FDP主要来自纤溶酶与交联纤维蛋白的相互作用，而不是与纤维蛋白原的条件下，这些进行了比较。
Plasma D-dimer was measured and compared with serum fibrinogen/fibrin degradation product levels (FDPs) in patients with disseminated intravascular coagulation (DIC) and other conditions associated with a hypercoagulable state. D-dimer (N < 200 ng/ml) was elevated in all 43 patients with DIC, in 48 of 59 patients with liver disease, in 22 of 27 patients with acute leukaemia at presentation, in 17 of 23 patients with malignant disease, in 29 od 39 women in the third trimester of a complicated pregnancy, in 17 of 18 patients with deep venous thrombosis and in only four of 27 patients with acute myocardial infartion. There was a significant correlation between plasma D-dimer and serum FDP levels (P < 0.01) as follows: DIC: r = 0.58, liver disease: r = 0.57, acute leukaemia: r = 0.84, malignancy: r = 0.87. The frequent elevation of D-dimer observed in liver disease, acute leukaemia, malignancy and complicated pregnancy indicates that a hypercoagulable state is a common occurrence in these conditions although in liver disease elevated levels resulting from a failure of normal clearance mechanisms cannot be excluded. The close relationship between D-dimer and FDP levels suggests that serum FDPs predominantly arise from the interaction of plasmin with crosslinked fibrin rather than with fibrinogen in the conditions in which these were compared.