通过使用年龄校正的D-二聚体值，可提高对疑似深静脉血栓形成（DVT）患者进一步进行血栓形成诊断的必要性预测。
Predicting the need for further thrombosis diagnostics in suspected DVT is increased by using age adjusted D-dimer values.
作者信息
Broen Kelly, Scholtes Brian, Vossen Renée
机构信息
Laboratory of Clinical Chemistry and Hematology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
Department of Internal Medicine, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
出版信息
Thromb Res. 2016 Sep;145:107-8. doi: 10.1016/j.thromres.2016.08.011. Epub 2016 Aug 12.
INTRODUCTION
Negative D-dimer values combined with clinical decision rules by Wells can help in excluding the diagnosis deep vein thrombosis (DVT). However, with increasing age D-dimer levels increase, possibly leading to false positive results.
MATERIALS AND METHODS
In this prospective study we compared the specificity and sensitivity of conventional D-dimer levels and age adjusted D-dimer levels in the diagnosis of DVT. We included 528 patients, all over 50years of age, of whom 117 had a DVT confirmed by duplex ultrasound.
RESULTS AND CONCLUSION
Age adjusted D-dimer cut-off values had higher specificity compared to conventional D-dimer values (24.6% vs. 8.5%) as well as a higher negative predictive value (91,8% vs. 89,7%). Therefore we conclude that age adjusted D-dimer levels could be used to exclude the diagnosis of DVT. Ultimately this could lead to the performance of less duplex ultrasounds reducing health care costs and discomfort for the patient.
引言
D - 二聚体阴性结果与韦尔斯临床决策规则相结合有助于排除深静脉血栓形成（DVT）的诊断。然而，随着年龄增长，D - 二聚体水平会升高，这可能导致假阳性结果。
材料与方法
在这项前瞻性研究中，我们比较了传统D - 二聚体水平和年龄校正后的D - 二聚体水平在诊断DVT中的特异性和敏感性。我们纳入了528名年龄均超过50岁的患者，其中117名经双功超声证实患有DVT。
结果与结论
与传统D - 二聚体值相比，年龄校正后的D - 二聚体临界值具有更高的特异性（分别为24.6%和8.5%）以及更高的阴性预测值（分别为91.8%和89.7%）。因此，我们得出结论，年龄校正后的D - 二聚体水平可用于排除DVT的诊断。最终，这可能会减少双功超声检查的次数，降低医疗成本并减轻患者的不适。
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