1例D-二聚体阴性的急性肺栓塞患者伪装成右侧肺炎伴胸腔积液，经CT肺动脉造影证实：病例报告及文献复习
An Acute Pulmonary Embolism Patient with Negative D-dimer Masquerading as Right Pneumonia with Pleural Effusion Proven by CT Pulmonary Arteriography: a Case Report and Literature Review.
作者信息
Ge Yan L, Zhuang Ya J, Zhang Qian, Wang Meng H, L Cong H, Zhang Hai F, Li Wen Q, Chen Yi, Zhang Shuang, Hao Chen, Zhang Ci, Zhu Xiao Y, Li Li Q, Fu Ai S
出版信息
Clin Lab. 2019 Jul 1;65(7). doi: 10.7754/Clin.Lab.2019.190117.
BACKGROUND
We report an acute pulmonary embolism with negative D-dimer masquerading as right pneumonia with pleural effusion proven by CT pulmonary arteriography (CTPA).
METHODS
Appropriate laboratory tests are carried out. The application of vascular ultrasound for the cause of left lower extremity edema. CTPA were performed when vascular ultrasound suggested the existence of venous thrombosis of left lower extremity.
RESULTS
Serum D-dimer was negative. Vascular ultrasound revealed left lower extremity venous thrombosis, CTPA demonstrated large emboli in the main pulmonary artery and main pulmonary artery branches.
CONCLUSIONS
Negative serum D-dimer is not safe to rule out acute pulmonary embolism. When CT shows peripheral triangle-shaped infiltrate with pleuritis or small pleural exudate, physicians should pay attention to pulmonary infarction.
背景
我们报告一例D - 二聚体阴性的急性肺栓塞，其表现为右肺炎伴胸腔积液，经CT肺动脉造影（CTPA）证实。
方法
进行了适当的实验室检查。应用血管超声检查左下肢水肿的原因。当血管超声提示存在左下肢静脉血栓形成时，进行CTPA检查。
结果
血清D - 二聚体为阴性。血管超声显示左下肢静脉血栓形成，CTPA显示主肺动脉和主肺动脉分支内有大的栓子。
结论
血清D - 二聚体阴性不能安全地排除急性肺栓塞。当CT显示外周三角形浸润伴胸膜炎或少量胸腔渗出液时，医生应注意肺梗死。
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