d-二聚体在Covid-19肺炎中的作用:炎症的敏感标志物、机械通气、血栓栓塞事件的预测因子和Covid-19后肺纤维化的早期标志物印度三级医疗机构的前瞻性多中心、观察性、干预性研究

S. Patil, Manojkumar Bhadake, Abhijit Acharya, G. Narwade
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引用次数: 2

摘要

简介:新冠肺炎肺炎是一种异质性疾病,对肺实质、气道和血管系统的影响各不相同,从而对肺功能产生长期影响。材料和方法:多中心、前瞻性、观察性和介入性研究包括1000例经RT PCR确诊的新冠肺炎病例。所有病例均采用HRCT胸部、血氧饱和度、炎症标志物D-二聚体作为入路点进行评估并随访。年龄、性别、合并症、BIPAP/NIV的使用以及是否存在肺纤维化的结果是关键观察结果。在选定的病例中,下肢静脉多普勒和CT肺动脉造影排除DVT或PTE。采用卡方检验进行统计分析。观察和分析:年龄(50岁)和性别(男性与女性)与D-二聚体水平有显著相关性。[p<0.00001]和[p<0.010]。进入点的CT严重程度评分与D-二聚体水平具有显著相关性。[p<0.00001]D-二聚体水平与住院前的疾病持续时间显著相关。[000001]合并症与D-二聚体水平有显著相关性。〔p<0.00001〕D-二聚体水平与氧饱和度显著相关。〔p<0.00001〕BIPAP/NIV要求与D-二聚体水平有显著相关性。[p<0.00001]住院期间BIPAP/NIV需求的时间与DDimer水平显著相关。[p<0.00001]住院期间随访D-二聚体滴度与进入点水平的正常和异常相比,与新冠肺炎后肺纤维化、深静脉血栓形成和肺血栓栓塞症显著相关。[p<0.00001]。结论:D-二聚体在预测新冠肺炎肺炎的严重程度和评估住院期间的治疗反应方面发挥着非常关键的作用,随访滴度在重症监护环境中的逐步或逐步干预中起着重要作用。
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Role of D-Dimer in Covid-19 pneumonia: sensitive marker of inflammation, predictor of mechanical ventilation, thromboembolic events and early marker of post covid-lung fibrosis; Prospective Multicentric, Observational, Interventional study in tertiary care setting in India
Introduction: Covid-19 pneumonia is heterogeneous disease with variable effect on lung parenchyma, airways and vasculature leading to long term effects on lung functions. Materials and methods: Multicentric, prospective, observational and interventional study included 1000 covid-19 cases confirmed with RT PCR. All cases were assessed with HRCT thorax, oxygen saturation, inflammatory marker as D-Dimer at entry point and follow up. Age, gender, Comorbidity and use BIPAP/NIV and outcome as with or without lung fibrosis were key observations. In selected cases, lower limb venous doppler and CT pulmonary angiography to rule out DVT or PTE. Statistical analysis is done by using Chi square test. Observations and analysis: Age (<50 and >50 years) and gender (male versus female) has significant association with D-Dimer level. [p<0.00001] & [p<0.010] respectively. CT severity score at entry point with D-Dimer level has significant correlation. [p<0.00001] D-Dimer level has significant association with duration of illness prior to hospitalization. [p<0.00001] Comorbidities have significant association with D-Dimer level. [p<0.00001] D-Dimer level has significant association with oxygen saturation. [p<0.00001] BIPAP/NIV requirement has significant association with D-Dimer level. [p<0.00001] Timing of BIPAP/NIV requirement during hospitalization has significant association with DDimer level. [p<0.00001] Follow-up D-Dimer titer during hospitalization as compared normal & abnormal to entry point level has significant association with post-covid lung fibrosis, deep vein thrombosis and pulmonary thromboembolism. [p<0.00001]. Conclusion: D-Dimer has documented very crucial role in covid-19 pneumonia in predicting severity of illness and assessing response to treatment during hospitalization and follow up titers have significant role in step-up or step-down interventions in critical care setting.
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