张丹.急性主动脉夹层患者血清标志物联合检测的临床意义[J].内科急危重症杂志,2019,25(6):458-462
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| DOI：10.11768/nkjwzzzz20190606 |
| 中文关键词: 急性主动脉夹层 D-二聚体 基质金属蛋白酶-9 血清标志物 联合检测 |
| 英文关键词: |
| 基金项目:家自然科学基金项目（No:81660085） |
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| 中文摘要: |
| 目的：探讨血清D-二聚体（D-Dimer）和基质金属蛋白酶-9（MMP-9）作为急性主动脉夹层（AAD）早期辅助诊断标志物的可行性。方法：纳入以胸痛为主诉并且经食管超声心动图（TEE）、主动脉CT血管成像(CTA)和磁共振血管造影（MRA）等确诊为AAD的患者60例为病例组，健康体检者28例为对照组。测定9种血清相关标志物浓度，利用ROC曲线辅助早期诊断AAD，并对灵敏度较高的指标进行逐渐增加的组合方式计算联合诊断时的灵敏度、特异性、诊断准确度等相关参数。结果：与对照组比较，病例组血清D-Dimer及MMP-9等各项指标均有不同程度的升高（P＜0.05或P<0.01），最佳早期诊断组合为D-Dimer+MMP-9+内皮素+调宁蛋白。结论：结论：D-Dimer、MMP-9可作为潜在的辅助AAD早期诊断标志物；联合各项血清标志物能有效提高诊断AAD的敏感度及准确度。 |
| 英文摘要: |
| Objective: To explore the feasibility of detecting the serum levels of D-Dimer, matrix metalloproteinase-9 as early diagnostic markers for acute aortic dissection (AAD). Methods: Sixty patients diagnosed as AAD with chest pain as the main complaint, by transesophageal echocardiography (TEE), aortic computed tomography angiography (CTA), and magnetic resonance angiography (MRA) were included in the case group, and 28 healthy adults served as control group. The concentrations of 9 related serum markers were detected, ROC curve was used to assist early diagnosis of AAD, and the combination of higher sensitivity indicators was gradually increased to calculate the sensitivity, specificity, diagnostic accuracy and other related parameters. Results: Compared with those of control group，concentrations of D-Dimer and MMP-9 significantly increased to varying degrees in the case group (P<0.01 or P<0.05). The best early diagnosis combination was MMP-9+D-Dimer+ET-1+Calponin. Conclusion: D-Dimer might be an early diagnostic marker for AAD. Combined detection of serum markers can improve the diagnostic sensitivity and accuracy of AAD. |
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