Spadaro Aldo, Tortorella Vincenza, Morace Carmela, Fortiguerra Agostino, Composto Paola, Bonfiglio Caterina, Alibrandi Angela, Luigiano Carmelo, De Caro Giuseppe, Ajello Antonino, Ferrau Oscar, Freni Maria-Antonietta
Department of Medicine and Pharmacology, Clinica Medica, Pad C-University Hospital, Via Consolare Valeria, Messina 98125, Italy.
World J Gastroenterol. 2008 Mar 14;14(10):1549-52. doi: 10.3748/wjg.14.1549.
To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration.
Seventy consecutive cirrhotic patients (M = 44, F = 26, mean age 65 years, SD +/- 13), observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites (n = 42) the test was repeated after ascites resolution.
Ascites was present in 42 patients (group A) and absent in 28 (group B). Group A patients had more advanced liver disease. Hepatocellular carcinoma (HCC) was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B (P = 0.001). High D-dimers were associated with presence of HCC (P = 0.048) only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels (P = 0.007), returning to normal in 17.
In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.
测量有腹水和无腹水的肝硬化患者的血浆D-二聚体水平，评估腹水消退对D-二聚体浓度的影响。
纳入2005年10月至2006年3月间连续观察的70例肝硬化患者（男性44例，女性26例，平均年龄65岁，标准差±13）。采用乳胶增强免疫比浊法检测循环中的D-二聚体水平。有腹水的患者（n = 42）在腹水消退后重复检测。
42例患者有腹水（A组），28例无腹水（B组）。A组患者的肝病更严重。14例患者被诊断为肝细胞癌（HCC），在B组中更常见。70例患者中有45例D-二聚体高于正常范围。A组中高D-二聚体的发生率高于B组（P = 0.001）。仅在B组中，高D-二聚体与HCC的存在相关（P = 0.048）。所有患者腹水消退后，34例基础水平高的患者的平均D-二聚体值下降（P = 0.007），17例恢复正常。
在肝硬化患者中，腹水和HCC是与纤溶活性增加相关的主要因素。
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