摘要：目的 探讨D-二聚体在急性心肌梗死溶栓治疗中的动态变化情况。方法 选取急性心肌梗死（acute myocardial infarction ， AMI）患者50例为实验组，以同期健康体检者30名为正常对照组，分别检测AMI组及对照组的D-二聚体基础水平；AMI组根据是否进行溶栓治疗分为溶栓组及非溶栓组，根据ST段是否抬高分为ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）组与非ST段抬高型心肌梗死（non-ST- segment elevation myocardial infarction，NSTEMI）组，分别检测各组治疗前及治疗后6h、12h、24h的D-二聚体水平，对各组数据间差异进行统计学分析。结果 基础状态AMI组D-二聚体水平高于对照组，但差异不具有统计学意义（P＞0.05）；溶栓组与非溶栓组治疗前血浆D-二聚体水平差异无统计学意义（P＞0.05）；溶栓组与非溶栓组治疗后6h、12h、24h血浆D-二聚体水平与治疗前相比均有显著性差异（P＜0.05）；STEMI组治疗前血浆D-二聚体水平高于NSTEM组，但差异无统计学意义（P＞0.05）；STEMI组与NSTEMI组治疗后6h、12h、24h血浆D-二聚体水平与治疗前相比均有显著性差异（P＜0.05）。结论 D-二聚体检测能显示AMI溶栓治疗的动态变化，对AMI的诊断、治疗和预后有较好的指导意义。

Abstract: Objective To investigate dynamic changes of D-dimmer in thrombolytic therapy of acute myocardial infarction cases. Methods 50 cases of acute myocardial infarction （AMI）patients were involved into this study. The AMI patients according to whether patients carried out thrombolytic therapy were divided into reperfusion group and non thrombolysis group. According to the ST segment elevation, the patients were divided into ST-segment elevation myocardial infarction (STEMI）group and non ST segment elevation myocardial infarction group (NSTEM）group. The D-dimmer levels in 50 cases patients before and after 6, 12 and 24 hours treatment, and 30 cases of healthy people were measured. Results The D-dimmer level in the basic state of AMI group was higher than the control group, but without statistically significant (P> 0.05). Before treatment, the D-dimmer level was no significant difference in the thrombolysis group and non thrombolysis group (P> 0.05). After 6h, 12h, 24h treatment, the D-dimmer levels in thrombolysis group and non thrombolysis group compared with those before treatment were significantly different (P<0.05). Before treatment, the D-dimmer level in the STEMI group was higher than the NSTEM group, but without statistically significant (P>0.05). After 6h, 12h, 24h treatment, the D-dimmer levels in STEMI group and NSTEMI group compared with those before treatment were significantly different (P<0.05). Conclusion The D-dimmer detection could display the dynamic evolution of AMI thrombolytic therapy. It could have significance in the diagnosis, treatment and prognosis on acute myocardial infarction.