摘要目的 通过连续检测尿激酶治疗急性髂-股静脉血栓模型兔血清D-二聚体值以及血栓溶解体积和血栓清除率结果,探讨三者间的关联性.方法 选择清洁级健康新西兰大白兔30只,制作急性髂-股静脉血栓模型,按照治疗方法分为3组,每组10只,A组:帕肝素+5％葡萄糖生理盐水;B组:帕肝素+尿激酶+5％葡萄糖生理盐水;C组(空白对照组):帕肝素+尿激酶+5％葡萄糖生理盐水.分别于造模前、造模成功后1h、每次尿激酶治疗后4h进行D-二聚体含量检测,计算静脉造影所显示血栓的体积及血栓清除率,对结果进行统计学分析.结果 A组和B组在开始治疗后D-二聚体测量值均先升高后降低,C组测量值无显著变化.3组尿激酶治疗各时间点D-二聚体测量值比较,差别均有统计学意义(P＜0.05),T3[(164.6 ±21.3)、(264.2±16.5)、(66.5±8.1) ng/ml]、T4[(131.2±11.8)、(94.3±6.5)、(65.3±7.7)ng/ml]、T5[(88.5±6.7)、(46.4±4.9)、(64.2±7.2)ng/ml]时间点3组间两两比较差异有统计学意义(P＜0.05).A组T3时间点D-二聚体峰值为(305.6±21.3) ng/ml,相应的血栓溶解体积为(6.04 ±3.21) ml,B组T3时间点D-二聚体峰值为(264.2±16.5)ng/ml,相应的血栓溶解体积为(2.13 ±0.49) ml(P ＜0.05);A组T5时间点D-二聚体测量值为(88.5±6.7)ng/ml,相应的血栓溶解体积为(1.95 ±0.75) ml,B组T5时间点D-二聚体测量值为(46.4 ±4.9) ng/ml,相应的血栓溶解体积为(0.56 ±0.18) ml,两组间比较差异有统计学意义(P＜0.05).结论 在尿激酶治疗急性髂-股静脉血栓模型兔的过程中血浆D-二聚体值并非随着血栓的溶解而进行性上升.D-二聚体测量值表现为先上升后下降,通过测定D-二聚体水平可作为前期的溶栓治疗效及最终血栓溶解起到预测作用.

abstractsObjective To assessthe correlation of serum D-dimer with thrombus removal volume and thrombus removal rate in the management animal models of acute iliofemoral deep venous thrombosis with urokinase.Methods 30 animal models of acute iliofemoral deep venous thrombosiswere made.Group A,10 rabbits with parnaparinsodium + 5％ glucose saline solution therapy.Group B,10 rabbits with urokinase + parnaparinsodium + 5％ glucose saline solution therapy.Group C,10 rabbits,the noreal control group with urokinase + parUaparinsodium + 5％ glucose saline solution therapy.The D-dimer level was tested at 6 time points pre and post urokinasetreatment,and the correlating thrombusremoval volume and thrombus removal rate was calculated.Results Group A and Group B after D-dimer measurements after the start of treatment were then decreased in group C had no significant changes in the measured value.Urokinase three time points D-dimer measurement,the difference was statistically significant (P ＜ 0.05),T3 [(164.6 ±21.3),(264.2±16.5),(66.5±8.1) ng/ml],T4 [(131.2±11.8),(94.3±6.5),(65.3±7.7) ng/ml],T5 [(88.5 ±6.7),(46.4 ±4.9),(64.2±7.2) ng/ml] among the three time points pairwise comparison group difference was statistically significant (P ＜ 0.05).A group T3 time point D-dimer peak (305.6 ± 21.3) ng/ml,corresponding thrombolytic volume (6.04 ± 3.21) ml,group B T3 time point D-dimer peak (264.2 ± 16.5) ng/ml,corresponding thrombolytic volume (2.13 ± 0.49) ml,(P ＜ 0.05);a group T5 time point D-dimer measurement value (88.5 ± 6.7) ng/ml,corresponding to the volume of thrombolytic (1.95 ± 0.75) ml,group B T5 time point D-dimer measurement value (46.4 ±4.9) ng/ml,corresponding thrombolytic volume (0.56 ±0.18) ml,the difference between the two groups was statistically significant (P ＜ 0.05).Conclusion The changes of serum D-dimer in the management of acute iliofemoral deep venous thrombosis was correlated withthrombus removal volume and thrombus removal rate,which may be used to predict the cure effect and prevent of deep venous thrombosis.