Gupta Shallu, Shekhawat V P S, Kaushik G G
Clin Lab. 2015;61(9):1187-95. doi: 10.7754/clin.lab.2015.150102.
A number of experimental studies have been put forth suggesting an important role of the hemostatic system in acute pancreatitis (AP) in the recent past. However, meaningful studies on clinical values of parameters of the hemostatic system in predicting pancreatitis associated complications are still scarce. In the current investigation, we evaluated the role of D-dimer to predict the severity of acute pancreatitis on day 1 of admission to the hospital.
A total of 160 subjects (75 mild AP + 35 severe AP + 50 healthy controls) were examined in the study. Biochemical and hemostatic parameters were compared between various groups of subjects on day 1 and day 3 of admission to the hospital.
Levels of prothrombin time (PT), fibrinogen, D-dimer, and C-reactive protein (CRP) were significantly higher in the severe AP group than in the mild AP group. Antithrombin III (AT III) levels were significantly lower in the severe AP group than in the mild AP group. D-dimer levels were 5 times higher than the reference limit in the severe group and 1.7 times higher than the reference limit in the mild group. This difference was statistically highly significant (< 0.0001). A positive correlation between D-dimer and CRP, D-dimer and fibrinogen, and between D-dimer and PT was recorded.
Estimation of the levels of D-dimer on admission day provides an accurate method for the identification of patients who will develop systemic complications in the further course of AP.
最近有多项实验研究表明止血系统在急性胰腺炎（AP）中起重要作用。然而，关于止血系统参数在预测胰腺炎相关并发症临床价值的有意义研究仍然很少。在本研究中，我们评估了D - 二聚体在入院第1天预测急性胰腺炎严重程度的作用。
本研究共检查了160名受试者（75例轻度AP + 35例重度AP + 50例健康对照）。比较了入院第1天和第3天不同组受试者的生化和止血参数。
重度AP组的凝血酶原时间（PT）、纤维蛋白原、D - 二聚体和C反应蛋白（CRP）水平显著高于轻度AP组。重度AP组的抗凝血酶III（AT III）水平显著低于轻度AP组。重度组D - 二聚体水平比参考限值高5倍，轻度组比参考限值高1.7倍。这种差异具有高度统计学意义（< 0.0001）。记录到D - 二聚体与CRP、D - 二聚体与纤维蛋白原以及D - 二聚体与PT之间呈正相关。
入院当天评估D - 二聚体水平为识别在AP后续病程中会发生全身并发症的患者提供了一种准确的方法。
