纤维蛋白D-二聚体检测在急诊医学中的作用。
Role of fibrin D-dimer testing in emergency medicine.
作者信息
Wakai A, Gleeson A, Winter D
机构信息
Department of Emergency Medicine, Beaumont Hospital, Dublin, Republic of Ireland.
出版信息
Emerg Med J. 2003 Jul;20(4):319-25. doi: 10.1136/emj.20.4.319.
OBJECTIVES
Systemic values of the fibrinolytic plasma marker fibrin D-dimer are raised in a variety of acute clinical conditions. D-dimer values can now be rapidly determined and used to aid diagnosis in emergency medicine. However, despite clinical guidelines, inappropriate and unnecessary measurement of D-dimer values is a significant clinical problem. An understanding of the pathophysiological basis and limitations of the value of D-dimer values may help reduce this problem. This review discusses the pathophysiology of the fibrinolytic system. The currently used assays, clinical indications, and limitations of D-dimer measurement are reviewed. Finally, the potential future clinical indications for measurement of D-dimer values in emergency medicine are discussed.
METHODS
Literature on D-dimer was identified from Medline, along with cross referencing from the reference lists of major articles on the subject
RESULTS
and conclusions: Systemic D-dimer values aids diagnosis, and is potentially a prognostic indicator, in a variety of clinical conditions in emergency medicine. However, it has limited specificity in patients with comorbid conditions. Although, currently, there is no standard D-dimer assay, immunoturbidimetric assays are the most suitable for use in emergency medicine
目的
纤维蛋白溶解血浆标志物纤维蛋白D - 二聚体的全身水平在多种急性临床病症中会升高。现在可以快速测定D - 二聚体水平，并将其用于急诊医学辅助诊断。然而，尽管有临床指南，但对D - 二聚体水平进行不恰当和不必要的检测仍是一个重大临床问题。了解D - 二聚体水平的病理生理基础和局限性可能有助于减少这一问题。本综述讨论了纤维蛋白溶解系统的病理生理学。对目前使用的检测方法、临床适应症以及D - 二聚体检测的局限性进行了综述。最后，探讨了急诊医学中D - 二聚体水平检测未来潜在的临床适应症。
方法
从Medline数据库中检索关于D - 二聚体的文献，并交叉引用该主题主要文章的参考文献列表。
结果与结论
在急诊医学的多种临床病症中，全身D - 二聚体水平有助于诊断，并且可能是一种预后指标。然而，在患有合并症的患者中其特异性有限。虽然目前尚无标准的D - 二聚体检测方法，但免疫比浊法最适合用于急诊医学。
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