CAJ | 학술논문

目的：探讨系统性硬化病（systemic sclerosis，SSc）与血浆D-dimer浓度的相关性以及纤溶系统在 SSc中可能发挥的致病作用机制。方法收集2013年1月～2014年1月沈阳军区总医院内分泌科SSc患者32名和35名健康体检人群，检测血浆D-dimer浓度，采用t检验和logistic回归分析其与对照组、肺动脉高压的相关性。结果健康组血浆D-dimer浓度为0.28±0.04μg／ml，SSc患者为0.31±0.05μg／ml，明显高于对照组，差异有统计学意义（t＝1.997，P＝0.008）；而在不同类型的 SSc患者中，与限制性患者D-dimer浓度（0.30±0.03μg／ml）相比，弥漫性患者（0.41±0.06μg／ml）明显升高，差异有统计学意义（t＝2.051，P＜0.001）；logistic回归分析发现，随着血浆D-dimer浓度的增高，病人发生轻度肺动脉高压的风险也升高，OR＝4.38，95％置信区间为2.59～8.91，P＝0.008。结论 SSc患者体内升高的血浆 D-dimer浓度反映了机体潜在的血栓纤溶系统激活，它有可能最终导致病人发生肺动脉高压与血栓性并发症。
목적：탐토계통성경화병（systemic sclerosis，SSc）여혈장D-dimer농도적상관성이급섬용계통재 SSc중가능발휘적치병작용궤제。방법수집2013년1월～2014년1월침양군구총의원내분비과SSc환자32명화35명건강체검인군，검측혈장D-dimer농도，채용t검험화logistic회귀분석기여대조조、폐동맥고압적상관성。결과건강조혈장D-dimer농도위0.28±0.04μg／ml，SSc환자위0.31±0.05μg／ml，명현고우대조조，차이유통계학의의（t＝1.997，P＝0.008）；이재불동류형적 SSc환자중，여한제성환자D-dimer농도（0.30±0.03μg／ml）상비，미만성환자（0.41±0.06μg／ml）명현승고，차이유통계학의의（t＝2.051，P＜0.001）；logistic회귀분석발현，수착혈장D-dimer농도적증고，병인발생경도폐동맥고압적풍험야승고，OR＝4.38，95％치신구간위2.59～8.91，P＝0.008。결론 SSc환자체내승고적혈장 D-dimer농도반영료궤체잠재적혈전섬용계통격활，타유가능최종도치병인발생폐동맥고압여혈전성병발증。
Objective To study correlation between systemic sclerosis(SSc)and plasma D-dimer and to reveal the probably rules of the fibrinolytic systems in SSc.Methods In 2013 January to 2014 January,cellected 32 patients with SSc and 35 with healthy controls to detected level of plasma D-dimer.Logistic and t student test were used for statistical analysis for correlation between SSc and pulmonary artery hypertension.Results When compared to healthy controls (0.28±0.04μg/ml),the level of plasma D-dimer were significantly increased in SSc patient (0.31±0.05μg/ml,t=1.997,P=0.008).After stratifying SSc patients according to disease subset,whereas patients with diffuse subset displayed substantially increased values (0.41±0.06μg/ml,t=2.051,P<0.001).The level of plasma D-dimer was associated with pulmonary artery hyper-tension (OR=4.38,95%CI=2.59~8.91,P=0.008).Conclusion Demonstrated that SSc patients with diffuse subset are characterized by increased plasma D-dimer values,reflecting a potential activation of fibrinolytic cascaded,which might finally predispose these patients to thrombotic complications and pulmonary artery hypertension.