The Analysis Of Plasma D-dimer Level In Acute Pulmonary Embolism、Acute Myocardial Infarction And Community Acquired Pneumonia

Objective: The objective of this study was to assess the difference of the concentrations of D-dimer in acute pulmonary embolism(APE)、acute myocardial infarction(AMI)and community acquired pneumonia(CAP).To investigate the clinical value of plasma D-dimer level.Methods: Collecting the clinical date of acute pulmonary embolism(APE)patients 、 acute myocardial infarction(AMI)patients and community acquired pneu--monia(CAP)patients at the First Affiliated Hospital of Dalian Medical University between January 2014 and January 2015,and detection of plasma D-dimer at the same time.The acute pulmonary embolism(PE)patients were divided into low risk group,medium low risk group and medium high risk group according to the s PESI and marker of myocardial injury.Determing the plasma D-dimer levels and analyzing the differences in different groups.Study the correlation of D-dimer level with the radiological severity indexes(Qanadli scores)of pulmonary embolism on computed tomography pulmonary angiography.Acute myocardial infarction(AMI)patients were divided into low risk group,medium risk group and high risk group according to the GRACE risk scores.Determing the plasma D-dimer levels and analyzing the differences in different groups.Study the correlation of D-dimer level with gensini scores.community acquired pneumonia(CAP)patients were divided into low risk group,medium risk group and high risk group according to the CURB-65 scores.And patients were placed into twe groups according to the lung computed tomography(CT):lobar and multilobar.Determing the plasma D-dimer levels and analyzing the differences in different groups.Analyzing the plasma D-dimer level between acute pulmonary embolism and acute myocardial infarction and acute pulmonary embolism 、 community acquired pneumonia whether were the differences.Applicationg of immune turbidmetric method to detect the plasma D-dimer,reference value is 0-550μg/L.Results: The median plasma D-dimer levels were 3585μg/L(95%CI:3790-6399.61μg/L)in acute pulmonary embolism(APE)group.The median plasma D-dimer levels were 375μg/L(95%CI:671.18-1451.42μg/L)in community-acquired pneumonia(CAP)group.The median plasma D-dimer levels were785μg/L(95%CI:1175.31-1932.73 μg/L)in acute myocardial infarction(AMI)group.Plasma D-dimer levels were all significantly higher than normal levels.Plasma D-dimer levels were significantly higher in APE in relation to ommunity-acquired pneumonia(CAP)group and acute myocardial infarction(AMI)group.The median of acute pulmonary embolism(APE)group plasma D-dimer levels were1410μg/L(95%CI:1200.2-2058.85μg/L)in low risk group,3700μg/L(95%CI:2789.44-5584.02μg/L)in medium risk group and 7710μg/L(95%CI:7775.07-16052.μg/L)in high risk group.There also has statistical significance between the differences of plasma D-dimer levels in 3 groups.The median of acute pulmonary embolism(APE)group radiological severity indexes(Qanadli indexes)of pulmonary embolism on computed tomography pulmonary angiography Were10%(95%CI:7.77-14.85)in low risk group,15%(95%CI:13.58-19.24)in medium risk group and 42%(95%CI:34.4-48.65)in high risk group.There also has statistical significance between the differences of plasma D-dimer levels in 3groups.The D-dimer level was statistically correlated with the radiological severity indexes(Qanadli indexes)of pulmonary embolism on computed tomography pulmonary angiography(r =0.676,P <0.05).The D-dimer level was positively correlated with Qanadli indexes.The median plasma D-dimer levels were350μg/L(95%CI:380.96-999.04μg/L)in low risk group and 570μg/L(95%CI: 80 5.44-2696.28μg/L)in medium risk group of community-acquired pneumonia(CAP)group.There also has statistical significance between the differences of plasma D-dimer levels in 2groups.The median plasma D-dimer in multilobar group is 340μg/L(95%CI:220.44-307.56μg/L),apparently higher than The levels570μg/L(95%CI:749.52-2292.77μg/L)in lobar group.The difference was statistically significant.The levels of acute myocardial infarction(AMI)group plasma D-dimer median were350μg/L(95%CI:323.23-797.91μg/L)in low risk group,815μg/L(95%CI: 899.65-1448.59μg/L)in medium risk group and 1650μg/L(95%CI:1717.12-36 18.57μg/L)in high risk group.The levels of plasma D-dimer in high risk group apparently higher than The levels in low risk group and medium risk group.There also has statistical significance between the differences of plasma D-dimer levels in 3 groups.The median Gensini scores of acute myocardial infarction(AMI)group 51(95%CI:51.14-61.30).The median Gensini scores of acute myocardial infarction(AMI)group were37(95%CI:34.24-53.19)in low risk group,46(95%CI:44.33-61.75)in medium risk group and 80(95%CI:57.59-73.01)in high risk group.There also has statistical significance between the differences of plasma D-dimer levels in 3 groups.The D-dimer level was statistically correlated with the Gensini scores(r =0.335,P < 0.05).The D-dimer level was positively correlated with Gensini scores.The levels of acute myocardial infarction(AMI)group plasma c Tn I median levels were71.83μg/L(95%CI:76.08-171.53μg/L)in low risk group,119.33μg/L(95%CI:117.88-201.9μg/L)in medium risk group and 134.59μg/L(95%CI:124.01-245.8μg/L)in high risk group.There has no statistical significance between the differences of plasma D-dimer levels in3 groups.Linear regression analysis revealed no significant association between D-dimer and c Tn I in patients(r=0.335,P>0.05).Conclusions: 1、The levels of plasma D-dimer in acute pulmonary embolism(APE)group apparently higher than The levels in community-acquired pneumonia(CAP)group and acute myocardial infarction(AMI)group.2、The D-dimer level was statistically correlated with the radiological severity indexes(Qanadli indexes)of pulmonary embolism on computed tomography pulmonary angiography;The levels of plasma D-dimer in high risk group apparently higher than The levels in low risk group and medium risk group.3、The D-dimer level of acute myocardial infarction(AMI)group was statistically correlated with the Gensini scores;But linear regression analysis revealed no significant association between D-dimer and c Tn I in patients;The levels of plasma D-dimer in high risk group apparently higher than The levels in low risk group and medium risk group.4、The levels of plasma D-dimer in low risk group apparently higher than The levels in high risk group;The levels of plasma D-dimer in multilobar group apparently higher than The levels in lobar group.