Abstract：Objective To investigate the levels of plasma D-dimer (D-D) and fibrinogen (FIB) in pulmonary tuberculosis (PTB) inpatients and PTB inpatients complicated with different lung diseases, and to explore their clinical significance. Methods Inpatients with PTB were selected as the research subjects during the study period from January to June, 2016. We determined and analyzed the differences in the plasma D-D and FIB levels in inpatients with simple PTB, PTB inpatients complicated with pneumonia, PTB inpatients complicated with tuberculous pleurisy, PTB inpatients complicated with chronic obstructive pulmonary disease (COPD) and 40 healthy controls. Results Seventy-five inpatients with simple PTB, 57 inpatients with PTB complicated with pneumonia, 38 inpatients with PTB complicated with tuberculous pleurisy, 30 inpatients with PTB complicated with COPD and 40 healthy controls were enrolled in the analysis. The differences in the plasma D-D and FIB levels were statistically significant among all the study groups (plasma D-D:H=57.118, P=0.000; plasma FIB: F=13.986, P=0.001). The plasma D-D level of more than 0.5 mg/L was considered as the positive cut-off value, and the positive rate of plasma D-D level in the group of PTB complicated with tuberculous pleurisy was the highest (65.79%), followed by the group of PTB complicated with COPD (59.67%), the group of PTB complicated with pneumonia (56.67%) and the group of simple PTB (44%). No positive case was detected in the healthy controls. The plasma FIB level of more than 4 g/L was considered as the positive cut-off value, and the positive rate of plasma FIB level in the group of PTB complicated with pneumonia was the highest (54.39%), followed by the group of PTB complicated with tuberculous pleurisy (47.37%), the group of PTB complicated with COPD (33.33%) and the group of simple PTB (30.67%). 1 positive case was detected in the healthy controls. Conclusions Among the inpatients with simple PTB, PTB complicated with tuberculous pleurisy, PTB complicated with pneumonia and PTB complicated with COPD, the plasma D-D and FIB levels are all elevated. Therefore, it is of great clinical value to monitor the plasma D-D and FIB levels for preventing thrombotic complications in PTB inpatients with different pulmonary diseases.
张小萍, 陈振华, 刘彬彬, 龚道方, 高源, 谭云洪. 肺结核合并不同肺部疾病住院患者血浆D-二聚体和纤维蛋白原检测的临床意义[J]. 实用预防医学, 2017, 24(10): 1255-1257.
ZHANG Xiao-ping, CHEN Zhen-hua, LIU Bin-bin, GONG Dao-fang, GAO Yuan, TAN Yun-hong. Clinical significance of detection of plasma D-dimer and fibrinogen in pulmonary tuberculosis inpatients complicated with different pulmonary diseases. , 2017, 24(10): 1255-1257.
[1] Sharif-Kashani B,Bikdeli B,Moradi A,et al.Coexisting venous thromboembolism in patients with tuberculosis[J].Thromb Res, 2010,125(5):478-480. [2] 黄彩芝,莫丽亚,张新萍,等.重症肺炎患儿血浆纤维蛋白单体与D-二聚体水平分析[J].实用预防医学,2016, 23(9):1065-1068. [3] Elsalam HMA, Mohamed MA, Gammal MSE, et al. Hypercoagulability in different respiratory diseases[J]. Egypt J Chest Dis Tuberc, 2013, 62(2):331-341. [4] 汤春梅,张言斌,吴桂锋,等.几种肺部疾病患者血浆 D-二聚体测定及其意义[J]. 广东医学,2007,28(7):1067-1068. [5] 卫生部政策法规司.中华人民共和国卫生标准汇编(2008年度,中)[M].北京:中国标准出版社,2010:237-248. [6] 中华医学会.临床诊疗指南/呼吸病学分册[M].北京:人民卫生出版社,2009:11-146. [7] Riley RS, Gilbert AR, Dalton JB, et al. Widely used types and clinical applications of D-Dimer assay[J]. Lab Med 2016,47(2):90-102 . [8] Komazaki Y,Sakakibara Y,Sakashita H,et al.Pulmonary thromboembolism with pulmonary tuberculosis[J].Kekkaku,2011,86(7):717-722. [9] Dentan C, Epaulard O, Seynaeve D, et al. Active tuberculosis and venous thromboembolism[J]. Clin Infect Dis, 2014,58(4):495-501. [10] Smeeth L,Cook C,Thomas S,et al.Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting[J].Lancet, 2006,367(9516):1075-1079. [11] Goncalves IM,Alves DC,Carvalho A,et al.Tuberculosis and venous thromboembolism:a case series[J].Cases J,2009,2:9333. [12] Samama MM, Combe S, Conard J, et al. Risk assessment models for thromboprophylaxis of medical patients[J]. Thromb Res, 2012,129(2):127-132. [13] Kahn SR, Lim W, Dunn AS, et al. Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed:American College of Chest Physicians Evidence-based Clinical Practice Guidelines[M]. Chest, 2012, 141:e195S-226S. [14] Kerr R, Stirling D, Ludlam CA. Interleukin 6 and haemostasis[J]. Br J Haematol, 2001, 115(1):3-12. [15] Song YJ,Zhou ZH,Liu YK, et al.Prothrombotic state in senile patients with acute xacerbations of chronic obstructive pulmonary disease combined with respiratory failure[J]. Exp Ther Med, 2013, 5(4):1184-1188. [16] 王冰冰, 张立, 郭明日,等.肺结核患者D-二聚体及纤维蛋白原检测的临床意义[J].国际检验医学杂志,2014,35(14):1942-1943.
2017, Vol. 24 
