重度烧伤患者纤维蛋白原和D-二聚体水平变化及其与预后的关系
Changes of fibrinogen and D-dimer in patients with severe burns and their relationship with prognosis
目的 探讨重度烧伤患者纤维蛋白原和D-二聚体水平变化及其与预后的关系.方法 选取重度烧伤患者90例为研究对象,根据患者预后分为死亡组(30例)和存活组(60例).比较两组患者入院后同时间点纤维蛋白原及D-二聚体的差异及变化规律.结果 入院后各时间点比较,死亡组纤维蛋白原均显著高于同时间点存活组[(5.9±1.5)g/L比(5.1±1.3)g/L,(8.8±2.2)g/L比(7.4±2.5)g/L,(7.6±2.8)g/L比(5.7±1.2)g/L,(7.1±2.5)g/L比(4.3±1.7)g/L],差异均有统计学意义(t=3.892、4.762、5.436、6.987,均P<0.05).入院后各时间点比较,死亡组D-二聚体均显著高于同时间点存活组[(743.4±226.2)ng/mL比(704.1±214.6)ng/mL,(935.4±256.9)ng/mL比(834.6±256.2)ng/mL,(846.3±291.5)ng/mL比(712.1±251.3)ng/mL,(756.7±232.8)ng/mL比(601.5±168.7)ng/mL],差异均有统计学意义(t=3.895、5.477、4.743、5.746,均P<0.05).存活组D-二聚体水平自入院后呈先升高后降低趋势,而死亡组纤维蛋白原及D-二聚体水平则呈双峰改变.结论 重度烧伤患者体内凝血功能存在明显的障碍,D-二聚体和纤维蛋白原水平越高,患者预后越差.
更多Objective To investigate the changes of fibrinogen and D -dimer levels in patients with severe burn and their relationship with prognosis .Methods 90 patients with severe burn were selected as the subjects .The patients were divided into the dead group (30 cases) and the survival group (60 cases) according to the prognosis of the patients.The differences and changes of fibrinogen and D -dimer at the same time after admission were compared between the two groups .Results At each time point after admission , the fibrinogen levels of the death group were significantly higher than those of the survival group at the same time [(5.9 ±1.5)g/L vs.(5.1 ±1.3)g/L,(8.8 ± 2.2)g/L vs.(7.4 ±2.5)g/L,(7.6 ±2.8)g/L vs.(5.7 ±1.2)g/L,(7.1 ±2.5)g/L vs.(4.3 ±1.7)g/L],the differences were statistically significant(t =3.892,4.762,5.436,6.987,all P <0.05).At each time point after admission,the D-dimer levels of the death group were significantly higher than those of the survival group at the same time[(743.4 ±226.2)ng/mL vs.(704.1 ±214.6)ng/mL,(935.4 ±256.9)ng/mL vs.(834.6 ±256.2)ng/mL, (846.3 ±291.5)ng/mL vs.(712.1 ±251.3) ng/mL,(756.7 ±232.8) ng/mL vs.(601.5 ±168.7) ng/mL],the differences were statistically significant (t=3.895,5.477,4.743,5.746,all P<0.05).The level of D-dimer in the survival group showed a rise firstly ,then showed a decrease trend after admission ,while the levels of fibrinogen and D-dimer of the death group were altered in double -peak change .Conclusion There is an obvious impairment of coagulation function in severe burn patients , and the level of D -dimer and fibrinogen is higher , the prognosis of patients is worse .
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