D-二聚体检测作为印度风湿性二尖瓣狭窄患者左心房血栓诊断的无创检查
D-Dimer assay as a non invasive test for the diagnosis of left atrial Thrombi in Indian patients with Rheumatic MS.
作者信息
Rajappa M, Sunil Roy T N, Raj A, Trehan V, Mallika V
机构信息
Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Department of Cardiology, Belhoul Speciality Hospital, Dubai, United Arab Emirates.
出版信息
Afr Health Sci. 2013 Sep;13(3):584-589. doi: 10.4314/ahs.v13i3.9.
BACKGROUND
Systemic embolism is a serious and sometime fatal complication of rheumatic MS.
OBJECTIVE
We assessed the predictive power of D-Dimer level to predict occurrence of left atrial (LA) thrombi in patients with rheumatic mitral stenosis (MS).
METHODS
D-dimer levels were analyzed for 24 patients with rheumatic MS with LA clot and 22 patients with rheumatic MS with no LA clot undergoing transeosophageal echocardiography. A level more than 4 µg/ml was taken as elevated to predict the presence of LA clot in the study groups.
RESULTS
For a cut-off value of 4 µg/ml, sensitivity was 66.67 % and specificity 100 % for prediction of LA clot and AUC 0.710. A cut-off value of less than 1 µg/ml, sensitivity was 91.67 % and 87. 5 % negative predictive value for ruling out presence of LA clot and AUC 0.721.
CONCLUSION
A higher value of D-dimer can predict the possible presence of a LA clot and very low value can predict absence of clot in patients with rheumatic MS.
背景
系统性栓塞是风湿性二尖瓣狭窄的一种严重且有时致命的并发症。
目的
我们评估了D-二聚体水平对预测风湿性二尖瓣狭窄（MS）患者左心房（LA）血栓形成的预测能力。
方法
对24例有LA血栓的风湿性MS患者和22例无LA血栓的风湿性MS患者进行经食管超声心动图检查，并分析其D-二聚体水平。在研究组中，将超过4μg/ml的水平视为升高，以预测LA血栓的存在。
结果
对于4μg/ml的临界值，预测LA血栓的敏感性为66.67%，特异性为100%，曲线下面积（AUC）为0.710。对于小于1μg/ml的临界值，排除LA血栓存在的敏感性为91.67%，阴性预测值为87.5%，AUC为0.721。
结论
较高的D-二聚体值可预测风湿性MS患者可能存在LA血栓，而极低的值可预测无血栓形成。
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