الفهرس 
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Abstract
The coexistence of pulmonary embolism (PE) and pneumonia
(known as infarction pneumonia) is a common diagnosis in the setting of
emergency medicine worldwide.
D-dimer has been shown to increase in patients who have disorders
that trigger fibrin production and catabolization; these disorders include
pulmonary emboli (PE), deep vein thrombosis (DVT), solid tumors,
leukemia, severe infections, trauma or a post-operative state, disseminated
intravascular coagulation (DIC), pregnancy, acute stroke, sickle-cell anemia,
congestive heart failure and chronic kidney failure.
A limited number of studies have examined the relationship
between pneumonia and plasma D-dimer levels thus this study was
conducted on 50 patients admitted to El-Mahalla Chest Hospital and chest
department, Menoufia university Hospitals to determine the cut-off
value of D-dimer in diagnosis of pneumonia and pulmonary embolism as
well as assessing the relation between severity of pneumonia, size of
pulmonary embolism and D-dimer level.
The demographic characteristics didn‘t significantly differ between
the two studied groups. The pneumonia severity index divided the
patients into 3 equal groups including mild, moderate and severe. The
degree of embolism was massive in 65% of patients and non-massive in
only 35%. Also, the D-dimer levels were significantly higher in
pulmonary embolism group than pneumonia group either in 1st day or 7th
day. The levels of D-dimer were significantly higher in day 1 in both
groups than day 7.
Statistically significant difference was found between different
grades of pneumonia and D dimer in comparing between mild and
moderate groups and between mild and severe groups in 1st day but non
significant difference between moderate and severe groups in 1st day.
However, no significant correlation were found between the levels of Ddimer
and severity of pneumonia in 7th day and between 1st and 7th day.
Also, the D-dimer levels were significantly associated with the severity of
pneumonia in 1st day however in the 7th day showed no significant
correlation with pneumonia.
The D-dimer was higher in non-massive embolism than massive
embolism in day 1 and day 7 but with no statistically significant
difference. The levels of D-dimer were significantly higher in both types
of embolism in day 1 than day 7.
The cut off value of D-dimer for diagnosis pneumonia is 2480
mg/L and for diagnosis of pulmonary embolism is 5618 mg/L.
There was no significant correlation between D-dimer levels and
CRP levels in pneumonia patients and D-dimer levels with CT
angiographic finding in PE patients either in 1st or 7th day.
In conclusion,
1..the levels of D-dimer were significantly higher in PE patients
than pneumonia patients in the 1st and 7th day.
2.. the D-dimer levels decreased rapidly within days in the PE
patients undergoing therapy, thus D-dimer levels might be useful for
evaluating the treatment response in PE patients.
3..There was significant difference between different grades of
pneumonia and D-dimer levels in 1st day but non significant difference in
7th day .
4..The D-dimer levels showed no correlation with severity of
embolism in both 1st and 7thdays .
5..The levels of D-dimer showed no correlation with CT
angiographic finding symptoms.