[Plasma D-dimer changes and prognostic implication in severe acute pancreatitis].

OBJECTIVE To study the role of plasma D-dimer in human severe acute pancreatitis (SAP) and its relationship with disease severity. METHODS A prospective study was performed. From February 2010 to June 2011, plasma concentration of D-dimer and the results of other routine laboratory tests were measured in 32 SAP inpatients at admission immediately and 24, 48, 72 hours after admission. Ranson scores were also recorded. The relationship between plasma concentration of D-dimer and the results of other routine laboratory tests, Ranson scores were analyzed, and so did the relationship between plasma concentration of D-dimer and severity of patient's condition. RESULTS (1) There were no obvious changes for plasma concentration of D-dimer and the results of other routine laboratory index in 32 SAP inpatients at each time points after admission. (2) Plasma concentration of D-dimer of SAP was positively related to white blood count (WBC), creatinine (Cr), prothrombin time (PT) and activated partial thromboplastin time (APTT) and negatively related to hematocrit (Hct), albumin and calcium (P<0.05 or P<0.01). Plasma concentration of D-dimer of SAP at 48 hours after admission had positive relationship with Ranson scores (r=0.729, P=0.001). (3) Plasma concentration of D-dimer of SAP inpatients in CT grade D, E stage were significantly higher than that in CT grade B, C stage (1.18±0.02 mg/L, 1.23±0.01 mg/L vs. 0.90±0.02 mg/L, 0.93±0.01 mg/L, all P<0.05). (4) Plasma concentration of D-dimer of SAP in inpatients with multiple organ failure (MOF) at 24 hours and 48 hours were significantly higher than that in inpatients without MOF (24 hours: 1.26±0.02 mg/L vs. 0.93±0.02 mg/L, 48 hours:1.25±0.02 mg/L vs. 0.93±0.02 mg/L, both P<0.05). CONCLUSION Plasma concentration of the D-dimer is significantly increased in SAP patients, and is related to the severity. The first plasma concentration of D-dimer of SAP after admission can well reflect severity of patient's condition.