中文摘要：

目的：通过动态观察ICU患者全身炎症反应综合征（SIRS）状态下不同时点D-二聚体水平,探讨非血栓病患者和血栓病患者D-二聚体变化的差异,并探索其影响因素。方法：162例入选者连续5 d每6 h一次复查血常规、CRP、D-二聚体水平和凝血功能。分别研究血栓病、非血栓患者及复合病变患者的D-二聚体峰谷水平的规律性变化及持续时间等方面差异;把年龄、性别、体温、基线心率、呼吸、基线氧合指数、白细胞计数（WBC）平均值、CRP平均值、SIRS状态、脓毒症状态、原发病、用抗凝剂或止血药情况作为自变量,D-二聚体平均值作为因变量,采用ENTER法引进多元线性回归模型,摸索影响复合病变患者D-二聚体水平的多元回归方程。结果：4组患者72 h内高峰时间均出现在30 h内,除全部为非栓塞病复合病变组外,低谷时间均在60-66 h左右;非栓塞病组均较栓塞为主组曲线波动大,下降支72 h后具有明显反弹和多峰多谷现象;复合病变组峰值和平均值均较单病种组高,下降支更长,其中栓塞病为主组峰值最高,全部为非栓塞病组平均值最高。原发病、CRP平均值、WBC平均值、SIRS状态和用药情况等自变量和D-二聚体平均值密切相关,关系最密切的为CRP平均值。结论：非栓塞组患者D-二聚体水平在峰值、谷值、平均值、波动幅度和下降到正常的时间等方面均有别于血栓病组。SIRS患者D-二聚体水平受炎症状态、用药情况和原发疾病等多种因素影响,炎症最容易导致非栓塞性复合病变患者的D-二聚体水平升高。

英文摘要：

Objective： To observe the changes of serum D-dimer levels of systemic inflammatory response syndrome（SIRS） patients in ICU in different time,to compare the D-dimer level between thrombosis patients and non-thrombosis patients,and to explore the related factors to D-dimer level.Methods： Blood routine examination,CRP,D-dimer levels and blood clotting of all 162 cases in ICU were detected every six hours within five successive days.The independent variables such as age,gender,baseline of heart rate,respiration rate,body temperature,oxygen index and average of WBC count,CRP,SIRS status,sepsis status,primary disease,the anticoagulant or hemostatic agents,and the average of D-dimer as the dependent variable were input into computer to build the multiple linear regression equation by ENTER method.Results： Within 72 hours,the D-dimer level of all patients reached to the peak before 30 hours and fell to the valley in 60-66 hours except for the patients with non-thrombosis diseases.The D-dimer level curve of non-thrombosis disease patients had greater fluctuation than thrombosis disease patients and had a rebounded descending branch with multiple peaks and valleys after 72 hours.Complex lesions group had higher peak and average values and a longer descending branch than single disease group.The highest peak value appeared in thrombosis disease-based patients and greatest average value appeared in non-thrombosis diseases group.The variables of primary disease,sepsis status,medicines used,average of ALT,WBC count and CRP were closely related to D-dimmer,and the average of CRP was the closest related factor.Conclusion： D-dimer levels of non-thrombosis patients are different from thrombosis disease-based patients in the peak,valley,and average values,fluctuation extent,and the time come back to normal.The D-dimer levels in patients with SIRS are mainly affected by the inflammatory state,the medicines used,organ function and the primary disease.Inflammatory is most likely to lead to elevate the levels of D-dimer in