目的探讨影响老年患者血浆D-二聚体水平的相关因素。方法入选老年住院患者578例，自动化定量乳胶凝聚比浊法测定血浆D-二聚体水平，根据其检测结果分为正常组（<0.4 mg/L）和升高组（≥0.4 mg/L），比较2组间主要临床指标的差异，并分析引起D-二聚体水平升高的影响因素。结果升高组患者的年龄、C反应蛋白水平、凝血酶原时间、2型糖尿病、恶性肿瘤及细菌性肺炎和(或)慢性支气管炎急性发作的发生比例均高于正常组，而总胆固醇及低密度脂蛋白胆固醇水平则低于正常组（P<0.05）。血浆D-二聚体水平与年龄、C反应蛋白呈正相关（r分别为0.254、0.265，均P<0.05）。年龄增长、CRP升高，及存在恶性肿瘤、2型糖尿病、细菌性肺炎和(或)慢性支气管炎急性发作是引起老年患者血浆D-二聚体水平升高的影响因素。结论高龄，存在2型糖尿病、恶性肿瘤和（或）急性炎症状态是引起老年患者血浆D-二聚体水平升高的重要因素。%Objective To investigate the correlative factors affecting the plasma D-dimer level in elderly patients. Methods Five hundred and seventy-eight hospitalized elderly patients were included in this study. All participants were di-vided into normal group (<0.4 mg/L) and elevated group (≥0.4 mg/L) according to the plasma D-dimer value,which was mea-sured by automated quantitative turbidimetric latex agglutination test. The differences in clinical indicators were compared be-tween two groups. The factors leading to the increased plasma levels of D-dimer in elderly patients were also analyzed. Results It was found that the patient age, C-reactive protein, prothrombin time, proportions of type 2 diabetes mellitus, ma-lignant tumor, bacterial pneumonia and (or) acute exacerbation of chronic bronchitis were significant higher in elevated group than those of normal group (P<0.05), but the levels of total cholesterol and low density lipoprotein cholesterol were lower in elevated group than those of normal group (P<0.05). There was a positive correlation between serum level of D-dimer and age, C-reactive protein (r=0.254 and 0.265, P < 0.05). Binary logistic regression analysis showed that the factors affecting plasma D-dimer level of elderly patients were aging, elevated C-reactive protein level, existing of malignant tumor, type 2 dia-betes mellitus, and bacterial pneumonia and (or) acute exacerbation of chronic bronchitis. Conclusion Aging, existing of type 2 diabetes mellitus, malignant tumor, or acute inflammatory state were the important factors leading elevated plasma D-dimer levels in elderly patients.
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