Objective To investigate the clinical value and their changes of plasma fibrinogen (FIB) and D- dimer (D-D) levels in patients with acute hematogenous disseminated pulmonary tuberculosis complicated with acute respiratory distress syndrome.
Methods From January 2015 to December 2016, 118 patients with acute hematogenous disseminated pulmonary tuberculosis complicated with ARDS were enrolled in this study. The above patients were set as observation group and 118 patients with secondary pulmonary tuberculosis were selected as control group. The levels of FIB and D- dimer in the two groups were detected and compared. All patients were given comprehensive treatment, and the levels of FIB and D-dimer were detected and compared before and after treatment.
Results Before treatment, the plasma D-dimer and FIB levels in the observation group [(1.04±0.39), (4.80±1.15)] were significantly higher than those in the control group [(0.50±0.10), (2.72±0.46)] ( P<0.05). After treatment, the plasma D-dimer and FIB levels in the observation group [(0.51±0.11)和(2.78±0.56)] were significantly decreased ( P<0.05). There was no significant difference in plasma D- dimer and FIB levels between the observation group and the control group ( P>0.05).
Conclusion There is a hypercoagulable state in patients with acute hematogenous disseminated pulmonary tuberculosis, and the levels of FIB and D- dimer are abnormally elevated. Active treatment can reduce the above indicators and improve the hypercoagulable state. FIB and D-dimer can be used as important indicators for clinical diagnosis of acute hematogenous disseminated pulmonary tuberculosis patients.
摘要: 目的 探讨急性血行播散型肺结核合并急性呼吸窘迫综合征 (Acute respiratory distress syndrome, ARDS) 患者 体内血浆纤维蛋白原 (Fibrinogen, FIB) 与D-二聚体 (D-dimer) 水平变化的临床价值。 方法 收集2015年1月—2016年 12月就诊的118例急性血行播散型肺结核合并 ARDS 患者作为观察组, 选择同时间段内在西安市胸科医院就诊的118 例继发性肺结核患者设为对照组, 对两组研究对象的 FIB 及D-二聚体水平进行检测和比较。对全部患者实施综合性 治疗, 并对患者治疗前后的 FIB 及D-二聚体水平进行检测和比较。 结果 观察组患者治疗前血浆D-二聚体和 FIB 水 平分别为 (1.04±0.39) 和 (4.80±1.15), 对照组 (0.50±0.10) 和 (2.72±0.46), 差异有统计学意义 ( P<0.05) 。经过治疗后, 观 察组患者的血浆D-二聚体和 FIB 水平分别为 (0.51±0.11) 和 (2.78±0.56), 低于治疗前, 差异有统计学意义 ( P<0.05), 而 与照组数据差异均不具有统计学意义 ( P>0.05) 。 结论 急性血行播散型肺结核合并 ARDS 患者体内存在高凝状态, FIB 与D-二聚体水平异常上升。通过积极治疗可降低上述指标水平, 改善高凝状态。 FIB 与D-二聚体可作为急性血行 播散型肺结核患者临床诊断的重要指标。