Linkins L-A, Takach Lapner S
Department of Medicine, McMaster University, Hamilton, ON, Canada.
Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Int J Lab Hematol. 2017 May;39 Suppl 1:98-103. doi: 10.1111/ijlh.12665.
D-dimer assays are commonly used in clinical practice to exclude a diagnosis of deep vein thrombosis or pulmonary embolism. More recently, they have been also been used to guide patients with unprovoked venous thromboembolism (VTE) when faced with the decision to continue or stop anticoagulation after initial treatment is complete. D-dimer assays vary widely with respect to the antibody used, method of capture, instrumentation required, and calibration standard. These differences have an important influence on the operating characteristics of the assays. Consequently, the evidence available in the literature for one assay cannot simply be extrapolated to another. In this review, we will outline the general properties of D-dimer assays, discuss the concept of raising the D-dimer threshold used in diagnosis of VTE according to pretest probability and age, and provide clinical perspective on the role of D-dimer testing in the diagnosis and prognosis of VTE.
D-二聚体检测在临床实践中常用于排除深静脉血栓形成或肺栓塞的诊断。最近，它们还被用于指导初发治疗完成后面对继续或停止抗凝治疗决策的不明原因静脉血栓栓塞（VTE）患者。D-二聚体检测在所用抗体、捕获方法、所需仪器和校准标准方面差异很大。这些差异对检测的操作特性有重要影响。因此，文献中关于一种检测方法的现有证据不能简单地外推到另一种检测方法。在本综述中，我们将概述D-二聚体检测的一般特性，讨论根据检测前概率和年龄提高VTE诊断中使用的D-二聚体阈值的概念，并提供关于D-二聚体检测在VTE诊断和预后中作用的临床观点。
