Division of Hematology and Hematologic Malignancies, University of Utah Health Sciences Center, Salt Lake City, Utah.
Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
Am J Hematol. 2019 Jul;94(7):833-839. doi: 10.1002/ajh.25482. Epub 2019 Apr 19.
D-dimer is an indirect marker of fibrinolysis and fibrin turnover; this molecule exhibits unique properties as a biological marker of hemostatic abnormalities as well as an indicator of intravascular thrombosis. D-dimer is a soluble fibrin degradation product that results from the systematic degradation of vascular thrombi through the fibrinolytic mechanism. Because of this, the D-dimer serves as a valuable marker of activation of coagulation and fibrinolysis in a number of clinical scenarios. Most commonly, D-dimer has been extensively investigated for excluding the diagnosis of venous thromboembolism (VTE) and is used routinely for this indication. In addition, D-dimer has been evaluated for determining the optimal duration of anticoagulation in VTE patients, for diagnosing and monitoring disseminated intravascular coagulation, and for monitoring other conditions in which the patient is at high risk of bleeding or thrombosis. Limitations of the assay include D-dimer elevation in a constellation of clinical scenarios (age, pregnancy, and cancer) and lack of clinical standardization.
D-二聚体是纤维蛋白溶解和纤维蛋白转换的间接标志物；这种分子作为止血异常的生物标志物以及血管内血栓形成的指示剂具有独特的性质。D-二聚体是一种可溶性纤维蛋白降解产物，它是通过纤维蛋白溶解机制对血管血栓进行系统降解的结果。正因为如此，D-二聚体在许多临床情况下是凝血和纤维蛋白溶解激活的有价值的标志物。最常见的是，D-二聚体被广泛用于排除静脉血栓栓塞症（VTE）的诊断，并常规用于该适应症。此外，D-二聚体已被评估用于确定 VTE 患者抗凝治疗的最佳持续时间，用于诊断和监测弥散性血管内凝血，并用于监测患者有高出血或血栓形成风险的其他情况。该检测的局限性包括在一系列临床情况下（年龄、妊娠和癌症）D-二聚体升高，以及缺乏临床标准化。
