Objective To explore the association between the level of D-dimer and the severity of communi-ty-acquired pneumonia (CAP). Methods A retrospective study was performed by investigating D-dimer in 102 pa-tients with CAP,who were admitted to the Respiratory Medical Department of the Second Affiliated Hospital of Anhui Medical University. According to CURB-65 criteria, all the patients were divided into the low-risk,middle-risk and high-risk groups. Results The abnormal rate of D-dimer was 62. 1% ,100% and 95. 4% respectively in the low-risk,middle-risk and high-risk groups. The serum level of D-dimer in the middle-risk and the high-risk groups were (3. 007 ± 0. 329) ug/ ml and (5. 404 ± 1. 394) ug/ ml,which were both higher than that in the low-risk group (1. 068 ± 0. 134 ug/ ml)(P < 0. 05). The serum level of D-dimer in muti-lobular CAP was (3. 235 ± 0. 528) ug/ ml, which was higher than that in mono-lobular CAP (0. 992 ± 0. 167 ug/ ml). The serum level of D-dimer in pneumonia pa-tients with pleural effusion was (3. 154 ± 0. 501) ug/ ml,which was higher than that in pneumonia patients without pleural effusion (0. 890 ± 0. 151 ug/ ml). Conclusion The level of D-dimer is significantly higher in patients with CAP and its level is positively correlated with severity,which could be a good biomaker to assess the severity of CAP.%目的：探讨 D-二聚体和成人社区获得性肺炎(CAP)严重程度的相关性。方法回顾性分析安徽医科大学第二附属医院呼吸科2011年1月~2015年4月收治102例成人 CAP 住院患者不同危险分组中D-二聚体变化情况及肺炎累及范围、有无合并胸腔积液对 D-二聚体的影响,观察不同组间的差异。按 CURB-65标准将102例患者分为低危组、中危组和高危组。结果低、中、高危 CAP 患者 D-二聚体异常率分别为62．1%(36/58)和100%(22/22)、95．4%(21/22)。中、高危组 CAP 患者 D-二聚体测定值分别为(3．007±0．329) ug/ ml、(5．404±1．394) ug/ ml,均显著高于低危组(1．068±0．134) ug/ ml、,差异均具有统计学意义(P<0．05),D-二聚体与肺炎严重程度存在等级相关性。多肺叶 CAP 患者 D-二聚体水平(3．235±0．528) ug/ ml较单肺叶(0．992±0．167) ug/ ml 明显增高,差异具有统计学意义(P <0．05)。肺炎伴类肺炎性胸腔积液患者D-二聚体(3．154±0．501) ug/ ml 较未合并胸腔积液组(0．890±0．151) ug/ ml 显著增高,差异具有统计学意义(P <0．05)。结论 CAP 患者血浆 D-二聚体显著升高,且与病情严重程度存在相关性,肺炎范围及是否合并胸腔积液影响凝血功能,推测 D-二聚体可能成为重症 CAP 患者良好的预测指标。
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