知识与财富的链接
[目的]探讨弥漫性血管内凝血(DIC)敏感性和特异性较高的诊断指标应用于临床。[方法]选用BPC、PT、Fbg、APTT、DIC过筛诊断指标,3P、D-D二聚体、TT、FDP、ELT、ATⅢC、α2MG、VWFAg、乙醇胶、红细胞碎片确诊诊断指标,对1629例DIC各期病人及正常对照组进行检测比对分析,找出相关性。[结果]DIC前状态最敏感的指标是3P、ATⅢC、VWFAg,异常率高达100%;其次D-D二聚体,异常率为98.5%;BPC、PT、APTT半数以上异常,Fbg仅有1/3异常,其余各项指标敏感性较差;在消耗性低凝期VWFAg异常率持续增高,BPC、PT、TT异常率明显升高,而3P、ATⅢC、α2MG仅呈不同程度的增加;纤溶凝衰期时,FDP、ELT、D-D二聚体、红细胞碎片异常率高达100%,其他各项指标均有不同的异常改变。[结论]纤溶指标3P、D-D二聚体、ATⅢC可做DIC高凝前状态的诊断指标,BPC、PT、Fbg、VWFAg可做DIC过筛诊断指标,纤溶指标D-D二聚体、FDP、ELT、α2MG红细胞碎片可做DIC纤溶凝衰期诊断指标。因此,纤溶指标对DIC早期诊断及分型确诊诊断有重要实用价值。
[Objective] To explore the higher diagnostic indices in sensibility and specificity to apply to clinic.[Methods] We selected the sieving diagnostic indices such as BPC,PT,Fbg,APTT,DIC and the final diagnostic indices such as 3P,D-D dimer,TT,FDP,ELT,ATⅢC,α2MG,VWFAg,Alcohol mastic、bib to mesure a total of 1629 patients who were in different stages of DIC or normal comparison and find dependablities.[Results] The most sensitive indices before DIC were 3P,ATⅢC,VWFAg,and its anomal rate reached up to 100%.Of fibrinolysis has a great practical value in the typing and staging dignosis in DIC,the abnormal rate of D-D dimer was 98.5%,more than a half of BPC,PT,APTT and 1/3 of Fbg is preternatural,and other indices is poor in sensibility;the abnormal rate of VWFAg in analosis-low-clotting stage continuing to raise up,the abnormal rate of BPC,PT,TT advanced obviousely,and 3P,ATⅢC,α2MG only heightened at different degrees;During the stage of fibrinolysis exhaustion,the abnormal rate of FDP,ELT,D-D dimer and bib reached up to 100%,and other indices had preternatura transformation;[Conclusions]Firbrinolysis indices such as 3P,D-D dimer,ATⅢC can be regarded as the dignostic indices before DIC high clotting,BPC,PT,Fbg,VWFAg as the sieving diagnostic indices,firbrinolysis indices such as D-D dimer,FDP,ELT,α2MG,bib as the diagnostic indices of the stage of fibrinolysis exhaustion in DIC.Therefore,firbrinolysis indices have important and practical value in early diagnosis and grouping final diagnosis of DIC.
