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| 基于倾向性评分匹配法的血浆D-二聚体升高与新型冠状病毒肺炎重症化相关性研究 |
| Correlation between increasing plasma D-dimer level and acute exacerbation of coronavirus disease 2019 based on propensity score matching method |
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| DOI：10.3969/j.issn.1007-8134.2021.03.004 |
| 中文关键词: 新型冠状病毒肺炎 D-二聚体 重症化 倾向性评分匹配 |
| 英文关键词: coronavirus disease 2019 D-dimer acute exacerbation propensity score matching |
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| 中文摘要: |
| 目的 评估血浆D-二聚体（D-dimer, D-D）与新型冠状病毒肺炎（coronavirus disease 2019, COVID-19）重症化的相关性。方法 回顾性分析2020年1月20日—2月8日在阜阳市第二人民医院住院的102例COVID-19患者的临床资料，将患者按血浆D-D是否升高分为D-D不升高组与D-D持续升高组，比较2组患者的临床资料，并进行倾向性评分匹配及生存分析，评价D-D水平对于COVID-19重症化的作用。结果 最终纳入102例COVID-19确诊患者，中位年龄42.2（31.7，49.6）岁，60例（58.8%）为男性，19例（18.6%）存在基础疾病，6例（5.9%）有吸烟史，7例（6.9%）有间断饮酒史，74例（72.5%）有流行病学史。与D-D不升高组（n=85）相比，D-D持续升高组（n=17）患者的年龄更高，其中年龄＞50岁的患者占58.8%，淋巴细胞绝对值更低，LDH水平更高（P均＜0.05）。D-D持续升高组有8例患者出现了重症化（47.1%），D-D不升高组有7例（8.2%）出现重症化（P＜0.05）。基于多因素Logistic回归进行匹配，匹配成功后D-D升高组有8例（47.1%）患者出现了重症化，D-D不升高组有4例（11.8%）出现重症化（P＜0.05），CoX风险比例回归分析结果显示D-D持续升高是疾病进展的独立风险因素，其HR为4.372（95% CI: 1.313～14.556）。结论 血浆D-D的持续升高是COVID-19重症化的高危因素。 |
| 英文摘要: |
| Objective To evaluate the correlation between plasma D-dimer (D-D) level and acute exacerbation of coronavirus disease 2019 (COVID-19). Methods A retrospective analysis was performed for the clinical data of 102 COVID-19 patients who were admitted to the No. 2 People’s Hospital of Fuyang City from January 20, 2020 to February 8, 2020. The patients were divided into 2 groups according to the absence or presence of the increasing plasma D-D: non-increasing D-D group and continuously increasing D-D group. The clinical data of patients in 2 groups were compared. Propensity score matching and survival analysis were carried out to evaluate the impact of plasma D-D level on the acute exacerbation of COVID-19. Results Finally, 102 confirmed patients were included. Their median age was 42.2 (31.7, 49.6) years, including 60 (58.8%) male cases, 19 (18.6%) cases had underlying diseases, 6 (5.9%) cases had smoking history, 7 (6.9%) cases had intermittent drinking history, and 74 cases (72.5%) had epidemiological history. In the continuously increasing D-D group (n=17), the age of patients was higher and patients aged＞50 years accounted for 58.8%, the absolute lymphocyte count was lower. The LDH level was higher than that in non-increasing D-D group (n=85) (P＜0.05). Eight patients (47.1%) in the continuously increasing D-D group and 7 patients (8.2%) in the non-increasing D-D group developed acute exacerbation (P＜0.05). The propensity score matching was performed based on multivariate Logistic regression. After successful matching, 8 patients (47.1%) in the continuously increasing D-D group and 4 patients (11.8%) in the non-increasing D-D group developed acute exacerbation (P＜0.05). CoX risk proportional regression analysis showed that continuously increasing D-D was an independent risk factor for disease progression, with its hazard ratio (HR) of 4.372 (95% CI: 1.313-14.556). Conclusions The continuously increasing plasma D-D is a high-risk factor for acute exacerbation of COVID-19. |
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