Hasegawa Masahiro, Wada Hideo, Yamaguchi Toshio, Wakabayashi Hiroki, Fujimoto Naoki, Matsumoto Takeshi, Hasegawa Kei, Yamada Norikazu, Ito Masaaki, Yamashita Yoshiki, Katayama Naoyuki, Nakatani Kaname, Sudo Akihiro
1 Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
2 Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Tsu, Japan.
Clin Appl Thromb Hemost. 2018 May;24(4):655-662. doi: 10.1177/1076029617706755. Epub 2017 May 8.
The cutoff values of D-dimer levels for diagnosing or predicting the occurrence of deep vein thrombosis (DVT) were evaluated in preoperative patients and compared to those in non-DVT patients. The levels of 8 different D-dimers were measured using the latex agglutination method or enzyme immunoassay before surgery in 262 orthopedic surgery patients to diagnose subclinical DVT or predict postoperative DVT. There were 15 patients with subclinical DVT and 47 with postoperative DVT, but 200 patients had no DVT at all. All 8 plasma D-dimer values were significantly higher in the patients with subclinical or postoperative DVT than in those without DVT or in healthy volunteers. There were differences in the cutoff values between the assays highly sensitive for low D-dimer levels and wild-range assays of D-dimers. Some D-dimer assays might therefore be more useful than others for diagnosing low levels of D-dimer. Although the measurement of D-dimer levels was useful for diagnosing subclinical DVT and predicting the risk of DVT, the cutoff values for the diagnosis or prediction of DVT varied. The cutoff values for the prediction of postoperative DVT were ≥1.7 µg/mL (D-dimer A-D) and ≥1.0 µg/mL (D-dimer E-H).
在术前患者中评估了D - 二聚体水平用于诊断或预测深静脉血栓形成（DVT）发生的临界值，并与非DVT患者的临界值进行比较。采用乳胶凝集法或酶免疫测定法，在262例骨科手术患者术前测量8种不同D - 二聚体的水平，以诊断亚临床DVT或预测术后DVT。有15例亚临床DVT患者和47例术后DVT患者，但200例患者根本没有DVT。亚临床或术后DVT患者的所有8种血浆D - 二聚体值均显著高于无DVT患者或健康志愿者。对低D - 二聚体水平高度敏感的检测方法与D - 二聚体的宽范围检测方法之间的临界值存在差异。因此，某些D - 二聚体检测方法可能比其他方法更有助于诊断低水平的D - 二聚体。虽然测量D - 二聚体水平有助于诊断亚临床DVT并预测DVT风险，但DVT诊断或预测的临界值各不相同。预测术后DVT的临界值为≥1.7μg/mL（D - 二聚体A - D）和≥1.0μg/mL（D - 二聚体E - H）。
