DFR、抗凝血酶III概况及其在急性肺栓塞中的应用
DFR, Antithrombin III Profile and Application in Acute Pulmonary Embolism
DOI: 10.12677/ACM.2023.13122637, PDF,   
作者: 吉米力古·吾吉, 韩利梅*, 刘顺苹:新疆医科大学第二附属医院呼吸内科,新疆 乌鲁木齐
关键词: 急性肺栓塞DFR抗凝血酶IIIAcute Pulmonary Embolisms DFR Antithrombin III
摘要: 急性肺栓塞是多种因素共同作用下发生的、可严重危及生命的一种疾病。因其临床表现、体征缺乏特异性,单一检测往往不足以满足诊断需要,误诊率及漏诊率大,病死率高。故在疾病初期采取何种有效的方式进行诊断已成为临床研究热题。D-二聚体为反映纤溶亢进的指标,纤维蛋白原为凝血的指标,DFR作为D-D与Fbg的比值,在一定程度上可以反映纤溶与凝血之间的平衡。抗凝血酶III具有显著的抗凝血作用,其水平下降影响机体抗凝作用,促进血栓形成。
Abstract: Acute pulmonary embolism is one of the most common acute and critical diseases occurring under the combined effect of many factors. Due to the lack of specificity of its clinical manifestations, the degree of severity varies, the misdiagnosis rate and missed diagnosis rate are large, and the death rate is high. Therefore, what kind of effective way to diagnose at the early stage of the disease has become a hot topic of clinical research. D-dimer is an indicator of hyperfibrinolysis, fibrinogen is an indicator of coagulation, and DFR, as the ratio of D-D to Fbg, can reflect the balance between fibri-nolysis and coagulation to a certain extent. Antithrombin III has a significant anticoagulant effect, and a decrease in its level affects the body’s anticoagulant effect and promotes thrombosis.
文章引用:吉米力古·吾吉, 韩利梅, 刘顺苹. DFR、抗凝血酶III概况及其在急性肺栓塞中的应用[J]. 临床医学进展, 2023, 13(12): 18751-18756. https://doi.org/10.12677/ACM.2023.13122637

参考文献

[1] 中华医学会呼吸病学分会肺栓塞与肺血管病学组, 中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会, 全国肺栓塞与肺血管病防治协作组. 肺血栓栓塞症诊治与预防指南[J]. 中华医学杂志, 2018, 98(14): 1060-1087.
[2] 支立敏, 张玉杰, 曹大龙, 李运成. 急性肺栓塞45例临床诊治分析[J]. 中华全科医学, 2017, 15(8): 1286-1288.
[3] Konstantinides, S.V., Barco, S., Lankeit, M. and Meyer, G. (2016) Management of Pulmonary Embolism: An Update. Journal of the American College of Cardiology, 67, 976-990. [Google Scholar] [CrossRef] [PubMed]
[4] 冯翠翠, 王芳, 韩雪, 等. 青年深静脉血栓伴肺栓塞患者的危险因素分析[J]. 首都医科大学学报, 2018, 39(3): 335-340
[5] Jiménez, D., de Miguel-Díez, J., Guijarro, R., et al. (2016) Trends in the Management and Outcomes of Acute Pulmonary Embolism: Analysis from the RIETE Registry. Journal of the American College of Cardiology, 67, 162-170. [Google Scholar] [CrossRef] [PubMed]
[6] Friedman, T., Winokur, R.S., Quencer, K.B. and Madoff, D.C. (2018) Patient Assessment: Clinical Presentation, Imaging Diagnosis, Risk Stratification, and the Role of Pulmonary Embolism Response Team. Seminars in Interventional Radiology, 35, 116-121. [Google Scholar] [CrossRef] [PubMed]
[7] 李双拾, 远丽娜. BNP、TNI、Hcy和UA与急性肺栓塞相关性分析[J]. 解放军预防医学杂志, 2019, 37(11): 67-68.
[8] Kruger, P.C., Eikelboom, J.W., Douketis, J.D. and Hankey, G.J. (2019) Pulmonary Embolism: Update on Diagnosis and Management. The Medical Journal of Australia, 211, 82-87. [Google Scholar] [CrossRef] [PubMed]
[9] 雷丽均, 赵才林, 徐静. 急性肺栓塞的研究进展[J]. 中华肺部疾病杂志(电子版), 2022, 15(1): 127-128.
[10] Akgedik, R., Karamanli, H., Kurt, A. and Günaydın, Z.Y. (2018) Usefulness of Admission Red Blood Cell Distribution Width as a Predictor of Severity of Acute Pulmonary Embolism. The Clinical Respiratory Journal, 12, 786-794. [Google Scholar] [CrossRef] [PubMed]
[11] 贺芬宜, 严赟, 司徒明珠. 超声心动图联合下肢深静脉超声对急性肺栓塞诊断的临床价值研究[J]. 中国超声医学杂志, 2018, 34(12): 1084-1087.
[12] Viktoria, P., Fabian, R., Prabhakar, R., et al. (2020) Acute Pulmonary Embolism: Imaging Techniques, Findings, Endovascular Treatment and Differential Diagnoses. RöFo, 192, 38-49. [Google Scholar] [CrossRef] [PubMed]
[13] 问雷涛, 沈聪, 银楠, 等. 基于栓子形态与数量对急性肺栓塞患者心功能的预测价值[J]. 实用放射学杂志, 2018, 34(12): 1853-1856.
[14] 戚建晨, 王冬青, 张龙江, 等. 急性肺栓塞的影像检查技术应用进展[J]. 国际医学放射学杂志, 2021, 44(4): 434-437.
[15] 方年新, 刘镇威, 叶观生, 等. 血清D-二聚体水平联合Caprini评分诊断肺栓塞的价值探讨[J]. 中国临床新医学, 2022, 15(4): 336-340.
[16] Konstantinides, S.V., Meyer, G., Becattini, C., et al. (2020) 2019 ESC Guidelines for the Diagno-sis and Management of Acute Pulmonary Embolism Developed in Collaboration with the European Respiratory Socie-ty(ERS): The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). European Heart Journal, 41, 543-603.
[17] 沈酥雯, 袁洪新, 袁鹏, 等. 调整阈值的D-二聚体联合Wells评分、修正Geneva评分诊断下肢深静脉血栓形成患者非高危肺血栓栓塞症风险的价值[J]. 介入放射学杂志, 2022, 31(11): 1089-1092.
[18] 胡慧霞, 郭晓倩, 李艳. 冠心病患者D-二聚体/纤维蛋白原比值变化及与Gensini评分的关系[J]. 微循环学杂志, 2020, 30(2): 27-29, 38.
[19] Danesh, J., Collins, R., Peto, R. and Lowe, G.D.O. (2020) Haematocrit, Viscosity, Erythrocyte Sedimentation Rate: Meta-Analyses of Prospective Studies of Coro-nary Heart Disease. European Heart Journal, 21, 515-520. [Google Scholar] [CrossRef] [PubMed]
[20] 马林, 张春秀, 拜文廉. 血浆纤维蛋白原水平与非瓣膜性心房颤动患者左心耳血栓形成的关系[J]. 中国医药, 2022, 17(3): 376-380.
[21] Wen, H. and Chen, Y. (2021) The Predic-tive Value of Platelet to Lymphocyte Ratioand D-Dimer to Fibrinogen Ratio Combined with WELLS Score Onlower Ex-tremity Deep Vein Thrombosis in Young Patients with Cerebral Hemorrhage. Neurological Sciences, 42, 3715-3721. [Google Scholar] [CrossRef] [PubMed]
[22] 刘岩, 腾飞, 何新华, 等. 红细胞计数和纤维蛋白原联合血小板计数预测急性肺栓塞危险分层的价值[J]. 中华急诊医学杂志, 2020, 29(6): 829-834.
[23] 范行海, 蔡靖宇, 何亮. D-二聚体与纤维蛋白原比值在髋部骨折并发下肢深静脉血栓诊断中的应用价值[J]. 医学信息, 2017, 30(3): 101-102.
[24] 黄玉芳, 龙瀛, 欧国春, 罗文, 王述红, 邱容. IMA、IL-38、DFR水平与急性肺栓塞患者危险分层和预后的相关性[J]. 中南医学科学杂志, 2022, 50(2): 219-222.
[25] Giordano, N.J., Jansson, P.S., Young, M.N., Hagan, K.A. and Kabrhel, C. (2017) Epidemiology, Pathophysiology, Stratification, and Natural History of Pulmonary Embolism. Techniques in Vascular and Interventional Radiology, 20, 135-140. [Google Scholar] [CrossRef] [PubMed]
[26] 花云, 张婷婷, 葛红兵, 等. 血清肝素结合蛋白与抗凝血酶Ⅲ和Toll样受体4水平预测重症感染患者生存状况的临床价值[J]. 中华医院感染学杂志, 2022, 32(18): 2734-2737.
[27] 李大千, 蒋云, 梅燕萍. 抗凝血酶III、D-二聚体与纤维蛋白原在下肢静脉血栓形成中的临床应用[J]. 医学信息, 2019, 32(17): 167-169.
[28] 李相磊, 赵轶敏, 马春燕, 高标, 黄利娜, 李航. 肺血栓栓塞症患者血浆蛋白S、蛋白C和抗凝血酶III活性变化及其临床价值分析[J]. 中国卫生检验杂志, 2018, 28(8): 981-983.
[29] Choi, S.W., Kim, B.B., Choi, D.H., et al. (2017) Stroke or Left Atrial Thrombus Prediction Using Antithrombin III and Mean Platelet Volume in Patients with Nonvalvular Atrial Fibrillation. Clinical Cardiology, 40, 1013-1019. [Google Scholar] [CrossRef] [PubMed]
[30] 林晶, 陈佳龙, 吴淡森, 石松菁. 抗凝血酶III在急性肺动脉血栓栓塞症中预测院内死亡及优化危险分层的应用[J]. 中国呼吸与危重监护杂志, 2021, 20(3): 189-194.