A Study On Clinical Significance Of2000Patients With Elevated D-dimer Levels

Objective: To investigate the disease type of hospitalized patients with elevatedD-dimer and clinical significance of elevated D-dimer in. general hospitalsMethods: A retrospective analysis of the the clinical data of2,000patient caseswith elevated D-dimer from June2013to September2013was Implemented. SAS9.1software is used for statistical analysis. Data were undergone normality test and wereregarded as discrete distribution due to the standard deviation> mean. The quartilesrepresent the degree of dispersion and the non-parametric Wilcoxon test are used forthe statistics.Results:①2000patients with elevated D-dimer group of diseases can be dividedinto the following categories: cancer, cardiovascular disease, infectious disease,trauma, gynecological diseases, kidney disease, eye disease, benign tumor andauto-immune diseases. Among those diseases, elevated levels of D-dimmer wasincreased most prominently in traumatic diseases with statistical significance whencompared with other diseases.②In this group there are459patient cases of cancerwith elevated D-dimer, including94lung cancer patients with the most obviousmedian of elevated D-dimer as879ng/ml, but there is no statistical significance whencompared with other cancer groups. The comparison between the lung cancer groupand pure pneumonia group showed the patients in the former group has a evidentlyhigher D-dimer level,P<0.01. The comparison of patients with pneumonia withpleural effusion and with pure pneumonia showed that the former has a manifestlyhigher D-dimer level with statistical significance, P<0.01. The comparison betweenthe lung abscess group and simple pneumonia showed that the former has anincreased D-dimer level with the P<0.01.③There are197cases of gynecologicaldisease with D-dimer elevation,including65cases of ovarian malignant tumors,21 cases of benign ovarian disease,64cases of uterine malignant tumors.The ovarianmalignant tumors has the most prominent rise of the D-dimer with statisticalsignificance when compared with benign disease, P<0.01. When the ovarian anduterine malignant tumors are compared, the results showed that a significantly higherD-dimer level in ovarian cancer than the uterine cancer. There is no statisticalsignificance in the D-dimer elevation level between uterine fibroids and uterinemalignant tumors.④There are26cases of liver cancer,23cases of cirrhosis,3cases ofhepatitis with D-dimer elevation.⑤There are102cases causing the elevated D-dimerincluding37gastric cancer cases and52colorectal cancer cases. Other6casesincludes duodenum cancer, ileum cancer. Statistics found that there is no evidentstatistical significance difference of the D-dimer elevation level in GI malignanttumor. The D-dimer level elevation was significantly higher in colorectal cancer whencompared with intestinal polyps with statistical significance.⑥There are total23cases of D-dimer elevation by pancreatic cancer and pancreatitis without significantstatistical difference. In acute pancreatitis, the rise of D-dimer level is more in severepatients than the mild patients with statistical significance,P<0.01.⑦The rise ofD-dimer level in gangrenous and perforated appendicitis were significantly higherthan non-gangrenous appendicitis with statistical significance, P<0.01.⑧In the363cases of cardiovascular diseases with D-dimer elevation,including23cases of arterydissection,65cases of myocardial infarction,123cases of unstable angina, the biggestelevation of the D-dimer occurs in the patients with aortic dissection with statisticalsignificance when compared with unstable angina and myocardial infarction. Whenthe myocardial infarction unstable angina patients are compared with the elevationlevel of D-dimer, we found that the former far exceeds the latter with statisticalsignificance, P<0.05. There are293cardiovascular patients with classified cardiacfunction, statistics show that the elevation level of D-dimer in class III and IV ofcardiovascular patients obviously exceeds those with class I and II. Class IV patientswith cardiac function has the most prominent elevation of the D-dimer with statisticalsignificance when compared with other groups (P <0.05).⑨Among those bonefracture patients with elevated D-dimer, the most prominent elevation of the D-dimer is the patients with multiple fractures. When comparisons are made, we found that thedegree of elevation level of the D-dimer is: multiple fracture>tibia and fibula fractures> femur fracture> Spine> limb bone> pedal> orbital wall.Conclusion:1. Variety of diseases can cause elevated D-dimer2. D-dimer levels in patients with lung cancer compared to patients withpneumonia increased significantly.3. Elevated D-dimer levels are significantly different in patients withbenign compared to patients with malignant ovarian disease.4. Elevated levels of D-dimer contribute to the identification ofintestinal polyps and colorectal cancer.5. Elevated levels of D-dimer associated with the severity ofinflammatory lesions.6. Elevated D-dimer values of various diseases till need to bedetermined by the epidemiological investigation of a large sample.