Leng O, Sitaraaman H B
Foundation Year 2 Doctor, Southern General Hospital,NHS Greater Glasgow and Clyde.
Acute Med. 2012;11(3):129-32.
The D-dimer assay's ability to exclude pulmonary thromboembolism (PTE) falls with age.1,2 Douma et al. have proposed an age-adjusted D-dimer threshold ([threshold, µg/l] = [age, years] x 10) for patients aged >50 years with low clinical risk of PTE.3 We retrospectively applied this threshold to patients who underwent computer tomographic pulmonary angiogram (CTPA) for suspected PTE during a 13 month period at a busy District General Hospital. Of the 423 patients >50 years old who underwent CTPA, 22 (5.2%) had D-dimer concentrations higher than the traditional threshold but lower than the age-adjust threshold, none of whom had evidence of PTE on CTPA. This suggests that use of the age-adjusted D-dimer threshold may reduce necessity for CTPA concept patients aged >50 years.
D - 二聚体检测排除肺血栓栓塞症（PTE）的能力随年龄增长而下降。1,2 Douma等人针对年龄大于50岁且PTE临床风险较低的患者提出了一个年龄校正的D - 二聚体阈值（[阈值，μg/l] = [年龄，岁]×10）。3我们回顾性地将此阈值应用于一家繁忙的区综合医院在13个月期间因疑似PTE接受计算机断层扫描肺动脉造影（CTPA）的患者。在423例年龄大于50岁接受CTPA检查的患者中，22例（5.2%）的D - 二聚体浓度高于传统阈值但低于年龄校正阈值，这些患者在CTPA上均无PTE证据。这表明使用年龄校正的D - 二聚体阈值可能会减少年龄大于50岁患者进行CTPA检查的必要性。
