Background It is known that the main role of D-dimer has been as an exclusionary test in patients with suspected venous thromboembolism.However,the D-dimer is increasingly beginning to find clinical utility as a marke...Background It is known that the main role of D-dimer has been as an exclusionary test in patients with suspected venous thromboembolism.However,the D-dimer is increasingly beginning to find clinical utility as a marker in the evaluation of the extent of the embolic disease.The aim of the study was to determine whether D-dimer levels predict the radiological markers of pulmonary embolism （PE） severity using Mastora score.Methods This prospective study involved 69 patients with acute PE proved by computed tomography pulmonary angiography （CTPA）.The D-dimer level was noted.A pulmonary artery obstruction index （PAOI; Mastora score） ≥21.3% indicated severe obstruction of PE.A right ventricle/left ventricle （RV/LV） ratio 〉0.9 indicated RV dysfunction.Results The median D-dimer level and PAOI were 765 μg/L （95% C/：750-1 205 μg/L） and 16.77% （95% CI：16.32%-23.06%）,respectively.The D-dimer level was positively correlated with PAOI （r=0.417,P 〈0.000 1）.PAOI ≥21.3% was associated with high D-dimer levels （median,993 μg/L （95% C/：856-1 841 μg/L）,Z=-2.991,P=0.003）.The D-dimer level was correlated with the RV/LV ratio （r=0.272,P=0.024）.RV/LV ratios 〉0.9 were associated with high D-dimer levels （median,880 μg/L （95% CI：764-1 360 μg/L）,Z=-2.070,P=0.038）.PAOI was positively correlated with the RV/LV ratio （r =0.390,P=0.001）.After three months,both the PAOI and D-dimer levels decreased （Z=-7.009,P 〈0.000 1; Z=-6.976,P〈0.000 1,respectively）.Conclusion D-dimer levels are positively correlated with PE burden and right ventricle dysfunction on CTPA,and can help monitor the therapeutic response.展开更多
A54-year-old male smoker was admitted to our .hospital after undergoing the drainage of a leftperitonsillar abscess. Ten days prior to admission （day 1）, he complained of a ＂scratchy＂ throat with a fever of 38.5℃...A54-year-old male smoker was admitted to our .hospital after undergoing the drainage of a leftperitonsillar abscess. Ten days prior to admission （day 1）, he complained of a ＂scratchy＂ throat with a fever of 38.5℃. He had an enlarged left tonsil with prominent exudate; white blood cell count （WCC） 8.8×109/L; platelet count （Plt） 103 × 109/L; chest X-ray was normal in a medical clinic. Then the patient received an intravenous injection of 4 million units of penicillin G every 6 hours and 500 mg of oral azithromycin once daily. But his condition worsened with a temperature of 41℃ and laryngoscopy confirmed a marked left-sided peritonsillar abscess which was drained. On day 10, the patient was transferred to our hospital after developing persistent fever, rigors, left-sided neck pain, pain on swallowing and purulent bloody sputum.展开更多
文摘Background It is known that the main role of D-dimer has been as an exclusionary test in patients with suspected venous thromboembolism.However,the D-dimer is increasingly beginning to find clinical utility as a marker in the evaluation of the extent of the embolic disease.The aim of the study was to determine whether D-dimer levels predict the radiological markers of pulmonary embolism （PE） severity using Mastora score.Methods This prospective study involved 69 patients with acute PE proved by computed tomography pulmonary angiography （CTPA）.The D-dimer level was noted.A pulmonary artery obstruction index （PAOI; Mastora score） ≥21.3% indicated severe obstruction of PE.A right ventricle/left ventricle （RV/LV） ratio 〉0.9 indicated RV dysfunction.Results The median D-dimer level and PAOI were 765 μg/L （95% C/：750-1 205 μg/L） and 16.77% （95% CI：16.32%-23.06%）,respectively.The D-dimer level was positively correlated with PAOI （r=0.417,P 〈0.000 1）.PAOI ≥21.3% was associated with high D-dimer levels （median,993 μg/L （95% C/：856-1 841 μg/L）,Z=-2.991,P=0.003）.The D-dimer level was correlated with the RV/LV ratio （r=0.272,P=0.024）.RV/LV ratios 〉0.9 were associated with high D-dimer levels （median,880 μg/L （95% CI：764-1 360 μg/L）,Z=-2.070,P=0.038）.PAOI was positively correlated with the RV/LV ratio （r =0.390,P=0.001）.After three months,both the PAOI and D-dimer levels decreased （Z=-7.009,P 〈0.000 1; Z=-6.976,P〈0.000 1,respectively）.Conclusion D-dimer levels are positively correlated with PE burden and right ventricle dysfunction on CTPA,and can help monitor the therapeutic response.
文摘A54-year-old male smoker was admitted to our .hospital after undergoing the drainage of a leftperitonsillar abscess. Ten days prior to admission （day 1）, he complained of a ＂scratchy＂ throat with a fever of 38.5℃. He had an enlarged left tonsil with prominent exudate; white blood cell count （WCC） 8.8×109/L; platelet count （Plt） 103 × 109/L; chest X-ray was normal in a medical clinic. Then the patient received an intravenous injection of 4 million units of penicillin G every 6 hours and 500 mg of oral azithromycin once daily. But his condition worsened with a temperature of 41℃ and laryngoscopy confirmed a marked left-sided peritonsillar abscess which was drained. On day 10, the patient was transferred to our hospital after developing persistent fever, rigors, left-sided neck pain, pain on swallowing and purulent bloody sputum.
