Bounameaux H
Département de Médecine, Hôpital Cantonal Universitaire de Genève, Suisse.
J Mal Vasc. 1992;17 Suppl B:91-2.
Plasma measurement of D-dimers (DD) with the Elisa technique is very useful in the diagnostic approach of venous thromboembolic diseases: a low level of plasma D-dimers (500 micrograms/l when using the Elisa from Stago) allows to exclude the diagnosis of deep venous thrombosis or pulmonary embolism with predictive values of 94% and 98%, respectively. Such a diagnostic potential is particularly useful in the group of patients with inconclusive perfusion-ventilation scintigraphy (low or indeterminate probability of pulmonary embolism) which represent more than 50% of the patients with suspected pulmonary embolism. Presence of pulmonary embolism is suggested by levels above 4.000 micrograms/l in the collective of outpatients who are urgently referred because of clinical suspicion of embolism.
采用酶联免疫吸附测定(ELISA)技术检测血浆D-二聚体(DD)在静脉血栓栓塞性疾病的诊断中非常有用:血浆D-二聚体水平较低(使用思塔高公司的ELISA检测时为500微克/升)可分别以94%和98%的预测值排除深静脉血栓形成或肺栓塞的诊断。这种诊断潜力在灌注-通气闪烁扫描结果不确定(肺栓塞可能性低或不确定)的患者群体中尤为有用,这类患者占疑似肺栓塞患者的50%以上。因临床怀疑栓塞而紧急转诊的门诊患者群体中,肺栓塞的存在可通过高于4000微克/升的水平提示。