Objective To investigate the possibility of plasma D-dimer (D-D) in helping low density lipopro-tein (LDL) to predict coronary heart disease (CHD). Methods The confirmed patients with CAD by coronary angiogra-phy (400 cases) and physical examination persons (55 cases) are collected. The mean ages were respectively (62.90 ± 5.70) and (50.40 ± 7.60) years old. The relationships among CAD and the LDL and D-D levels were analyzed by ROC curve. Results ROC curves showed a specificity of 60%and a sensitivity of 77%in diagnosis of CHD patients from 50 to 70 years, but the level of D-D was not effective in the diagnosis of CHD. The quality of LDL level diagnosis can be improved by using D-D levels to make up its shortage. Especially, when 0.2 mg/L of D-D level was taken as positive standard, the diagnostic specificity can reach 76.9%, and the sensitivity can reach 84.6%. Conclusion Detection of plasma D-D level can improve the accuracy of LDL levels in predicting CHD.%目的 探讨血浆D-二聚体(D-D)协助低密度脂蛋白(LDL)预测冠心病的可能性.方法 选取武汉大学人民医院2015年1~12月住院治疗经心血管造影确诊的冠心病患者400例,平均年龄(62.90±5.70)岁;非冠心病体检者55例,平均年龄(50.40±7.60)岁.使用SIEMENS ADVIA-2400全自动生化分析仪测定LDL水平,SYSMEX CA7000血凝仪测定D-D水平,ROC曲线分析两者与冠心病之间的关系.结果 ROC曲线显示50~70岁患者中LDL诊断冠心病有60%的特异性和77%的灵敏度,而D-D水平不能有效诊断冠心病;当考虑以D-D水平弥补LDL水平诊断的不足可以提高诊断质量,尤其以0.2 mg/L的D-D水平为判断标准时,诊断的特异性可达76.9%,灵敏度可达84.6%.结论 血浆D-D水平的检测可以改善LDL水平对冠心病预测的准确性.
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