ABSTRACT
ObjectiveLupus mesenteric vasculitis (LMV) can lead to extensive necrosis of the small intestine, and it is easy to be misdiagnosed and missed in the early stage of the disease. This study aims to evaluate the clinical significance of serum D-dimer level in the early diagnosis of LMV.MethodsRetrospective analysis was performed on 38 patients with systemic lupus erythematosus (SLE) admitted to Nanjing Drum Tower Hospital from January 2006 to January 2019. There were 15 LMV patients (LMV Group) and 23 non-LMV patients (Non-LMV Group). The main observation indicators of statistical analysis were serum D-dimer level on the first day of treatment in the two groups, while the secondary indicators included patient general condition, SLE disease activity index (SLEDAI), enhanced CT examination results, laboratory examination results and serum D-dimer level after treatment.ResultsThere was no significant difference in age, SLE duration and SLEDAI between the two groups (P>0.05). On admission, CT showed LMV patients with intestinal dilatation, mesenteric edema and typical target symptoms. After high-dose hormone therapy, the dilatation of intestinal canal and intestinal wall were significantly relieved, and the target signs on CT disappeared before discharge. The serum D-dimer level of patients in the LMV Group [917 (756,1848) μg/L] was significantly higher than that in the Non-LMV Group [570 (356,896) μg/L], and the difference was statistically significant (P=0.006). ROC curve analysis showed that the critical value of serum D-dimer in early diagnosis of LMV was 624 μg/L, and the sensitivity and specificity were 93% and 61%, respectively (AUC=0.77).ConclusionSerum D- dimer level can be used as an effective index for early diagnosis of LMV patients.
ABSTRACT
ObjectiveLupus mesenteric vasculitis (LMV) can lead to extensive necrosis of the small intestine, and it is easy to be misdiagnosed and missed in the early stage of the disease. This study aims to evaluate the clinical significance of serum D-dimer level in the early diagnosis of LMV.MethodsRetrospective analysis was performed on 38 patients with systemic lupus erythematosus (SLE) admitted to Nanjing Drum Tower Hospital from January 2006 to January 2019. There were 15 LMV patients (LMV Group) and 23 non-LMV patients (Non-LMV Group). The main observation indicators of statistical analysis were serum D-dimer level on the first day of treatment in the two groups, while the secondary indicators included patient general condition, SLE disease activity index (SLEDAI), enhanced CT examination results, laboratory examination results and serum D-dimer level after treatment.ResultsThere was no significant difference in age, SLE duration and SLEDAI between the two groups (P>0.05). On admission, CT showed LMV patients with intestinal dilatation, mesenteric edema and typical target symptoms. After high-dose hormone therapy, the dilatation of intestinal canal and intestinal wall were significantly relieved, and the target signs on CT disappeared before discharge. The serum D-dimer level of patients in the LMV Group [917 (756,1848) μg/L] was significantly higher than that in the Non-LMV Group [570 (356,896) μg/L], and the difference was statistically significant (P=0.006). ROC curve analysis showed that the critical value of serum D-dimer in early diagnosis of LMV was 624 μg/L, and the sensitivity and specificity were 93% and 61%, respectively (AUC=0.77).ConclusionSerum D- dimer level can be used as an effective index for early diagnosis of LMV patients.
ABSTRACT
Objective To investigate the differences of clinical symptoms,risk factors,plasma D?dimer level and severity of acute pulmonary embolism( APE) between females and males. Methods Clinical data of 153 cases APE patients were analyzed retrospectively. Symptoms,risk factors,electrocardiogram( ECG) findings, plasma D?dimer level and risk classification were analyzed between females and males. Results The proportion of palpitation in females was significantly higher than that in males ( 29. 3%( 24/82 ) vs. 8. 5%( 6/71 ) ,χ2=10. 46,P<0. 01) . The proportion of chest pain in females was significantly lower than that in males ( 4. 9%( 4/82) vs. 25. 4%( 18/71) ,χ2=12. 96,P<0. 01) . The proportion of patients who had three or more symptoms was significantly higher in females than that in males ( 32. 9%( 27/82 ) vs. 7. 0%( 5/71 ) ,χ2 = 15. 41, P<0. 01). D?dimer mean level in females was significantly higher than that in males(334. 00(620. 00) μg/L vs. 528. 00( 812. 75) μg/L,Z=-2. 447,P<0. 05) . The proportion of low risk patients in females was lower than that in males ( 31. 7%( 26/82 ) vs. 53. 3%( 38/71 ) ,χ2 = 7. 44, P<0. 01 ) , while the proportion of the intermediate?high?risk patients was higher ( 34. 1% ( 28/82 ) vs. 14. 1 ( 10/71 )%,χ2 = 8. 20, P<0. 01) . Conclusion The symptoms was more variable in females with the main symptom of palptation. The level of plasma D?dimer is higher in females than that in males. The prognosis of females may be severe than that of males.