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目的：探讨溶栓二聚体（Ｄ－Ｄｉｍｅｒ，Ｄ－Ｄ）对肺栓塞（Ｐｕｌｍｏｎａｒｙｅｍｂｏｌｉｓｍ，ＰＥ）诊断的临床意义及溶栓疗效监测的价值。方法：确诊为ＰＥ的３０例病人和非肺栓塞肺部其它疾病的病人２９例，同测Ｄ－Ｄ，比较二者阳性率。观察溶栓治疗前后溶栓二聚体的变化。２３９例临床可疑栓塞性疾病测定Ｄ－Ｄ的临床观察。结果：ＰＥ组Ｄ－Ｄ阳性率为８６６６％，对照组６９０％，ＰＥ组Ｄ－Ｄ阳性率明显高于对照组（Ｐ＜０．０１）。９例ＰＥ病人溶栓治疗后有７例Ｄ－Ｄ下降，并临床症状缓解。２３９例临床怀疑ＰＥ，下肢深静脉栓塞（ＤＶＴ），急性心肌梗塞（ＡＭＩ）的病人，Ｄ－Ｄ阳性率为４７２８％。结论：溶栓二聚体诊断ＰＥ敏感性高，特异性低，可作为临床检查的初步筛选手段。Ｄ－Ｄ阳性可进一步作有关检查如通气／灌注肺扫描、肺动脉造影等。Ｄ－Ｄ阴性基本上可排除ＰＥ。同时Ｄ－Ｄ可作为临床上观察溶栓疗效的一个指标。
Objective: To investigate the clinical significance of D-Dimer (D-D) in the diagnosis of pulmonary embolism (PE) and the value of thrombolytic therapy. Methods: Twenty-nine patients diagnosed with PE and 29 patients with other pulmonary diseases without pulmonary embolism were examined with D-D to compare the positive rates of the two. To observe the change of thrombolytic dimer before and after thrombolytic therapy. Clinical Observation of D-D in 239 Cases of Suspected Embolic Diseases. Results: The positive rate of D-D in PE group was 86.66% and that in control group was 6.90%. The positive rate of D-D in PE group was significantly higher than that in control group (P <0.01). Nine patients with PE had thrombolytic therapy after 7 cases of D-D decreased, and clinical symptoms were relieved. 239 cases of clinical suspicion of PE, deep vein thrombosis (DVT), acute myocardial infarction (AMI) patients, the positive rate of D-D was 4728%. Conclusion: Thrombolytic dimer is a sensitive and specific method for the diagnosis of PE. It can be used as a primary screening method for clinical examination. D-D positive for further tests such as ventilation / perfusion lung scan, pulmonary angiography. D-D negative can basically rule out PE. At the same time D-D can be used as a clinical observation of thrombolytic efficacy of an indicator.