1 Department of Cardiology, Respiratory Medicine and Intensive Care, University Hospital Augsburg, Augsburg, Germany.
2 Department of Radiology, University Hospital Augsburg, Augsburg, Germany.
Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029619863495. doi: 10.1177/1076029619863495.
D-dimer might be correlated with prognosis in pulmonary embolism (PE). The predictive value of plasma D-dimer for disease severity and survival was investigated in the lowest and highest D-dimer quartile among 200 patients with PE. Patients with high D-dimers were significantly more often hypotensive ( = .001), tachycardic ( = .016), or hypoxemic ( = .001). Pulmonary arterial obstruction index (PAOI) values were significantly higher in the high D-dimer quartile ( < .001). Elevated troponin I (TNI) levels ( < .001), simplified PE severity indices ≥1 ( < .001), right-to-left ventricular (RV/LV) diameter ratios ≥1 ( < .001), and thrombolysis ( = .001) were more frequent in the high D-dimer quartile. D-dimer was associated with RV/LV ratios ≥1 ( = .021), elevated PAOI ( < .001) or TNI levels ( < .001), hypotension ( < .001), tachycardia ( = .003), and hypoxemia ( < .001), but not with long-term all-cause mortality. D-dimer predicts disease severity but not long-term prognosis in acute PE, possibly due to a more aggressive treatment strategy in severely affected patients.
D-二聚体可能与肺栓塞（PE）的预后相关。在 200 例 PE 患者中，最低和最高 D-二聚体四分位中，研究了血浆 D-二聚体对疾病严重程度和生存的预测价值。高 D-二聚体患者明显更容易出现低血压（ =.001）、心动过速（ =.016）或低氧血症（ =.001）。高 D-二聚体四分位组的肺动脉阻塞指数（PAOI）值明显更高（ <.001）。高 D-二聚体四分位组中，肌钙蛋白 I（TNI）水平升高（ <.001）、简化 PE 严重指数≥1（ <.001）、右心室/左心室（RV/LV）直径比≥1（ <.001）和溶栓治疗（ =.001）更为常见。D-二聚体与 RV/LV 比值≥1（ =.021）、PAOI 升高（ <.001）或 TNI 水平升高（ <.001）、低血压（ <.001）、心动过速（ =.003）和低氧血症（ <.001）相关，但与长期全因死亡率无关。D-二聚体可预测急性 PE 的疾病严重程度，但不能预测长期预后，这可能是由于严重影响患者的治疗策略更为激进。
