Stokol T, Brooks M B, Erb H N, Mauldin G E
Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
Am J Vet Res. 2000 Apr;61(4):393-8. doi: 10.2460/ajvr.2000.61.393.
To determine sensitivity and specificity of assays of D-dimer concentrations in dogs with disseminated intravascular coagulation (DIC) and healthy dogs and to compare these results with those of serum and plasma fibrin-fibrinogen degradation product (FDP) assays.
20 dogs with DIC and 30 healthy dogs.
Semi-quantitative and quantitative D-dimer concentrations were determined by use of latex-agglutination and immunoturbidometry, respectively. Fibrin-fibrinogen degradation products were measured by use of latex-agglutination. A reference range for the immunoturbidometric D-dimer concentration assay was established; sensitivity and specificity of the assay were determined at 2 cutoff concentrations (0.30 microg/ml and 0.39 microg/ml).
Reference range for the immunoturbidometric D-dimer concentration assay was 0.08 to 0.39 microg/ml; median concentrations were significantly higher in dogs with DIC than in healthy dogs. Latex-agglutination D-dimer and serum and plasma FDP assays had similar sensitivity (85 to 100%) and specificity (90 to 100%); the immunoturbidometric assay had lower specificity (77%) at the 0.30 microg/ml cutoff and lower sensitivity (65%) at the 0.39 microg/ml cutoff. Sensitivity or specificity of the latex-agglutination D-dimer assay was not significantly improved when interpreted in series or parallel with FDP assays.
Measurement of D-dimer concentrations by latex-agglutination appears to be a sensitive and specific ancillary test for DIC in dogs. Specificity of D-dimer concentrations in dogs with systemic disease other than DIC has not been determined, therefore FDP and D-dimer assays should be performed concurrently as supportive tests for the diagnosis of DIC in dogs.
测定患有弥散性血管内凝血(DIC)的犬和健康犬D - 二聚体浓度检测的敏感性和特异性,并将这些结果与血清和血浆纤维蛋白 - 纤维蛋白原降解产物(FDP)检测结果进行比较。
20只患有DIC的犬和30只健康犬。
分别采用乳胶凝集法和免疫比浊法测定半定量和定量的D - 二聚体浓度。采用乳胶凝集法测量纤维蛋白 - 纤维蛋白原降解产物。建立免疫比浊法检测D - 二聚体浓度的参考范围;在2个临界浓度(0.30μg/ml和0.39μg/ml)下测定该检测方法的敏感性和特异性。
免疫比浊法检测D - 二聚体浓度的参考范围为0.08至0.39μg/ml;患有DIC的犬的中位数浓度显著高于健康犬。乳胶凝集法检测D - 二聚体以及血清和血浆FDP检测具有相似的敏感性(85%至100%)和特异性(90%至100%);免疫比浊法在临界浓度为0.30μg/ml时特异性较低(77%),在临界浓度为0.39μg/ml时敏感性较低(65%)。当乳胶凝集法检测D - 二聚体与FDP检测串联或并联解读时,其敏感性或特异性并未显著提高。
采用乳胶凝集法测定D - 二聚体浓度似乎是犬DIC的一种敏感且特异的辅助检测方法。尚未确定患有除DIC以外的全身性疾病的犬的D - 二聚体浓度的特异性,因此应同时进行FDP和D - 二聚体检测,作为犬DIC诊断的支持性检测。