Bongard O, Wicky J, Peter R, Simonovska S, Vogel J J, de Moerloose P, Reber G, Bonameaux H
Division of Angiology and Hemostasis, University Hospital of Geneva, Switzerland.
Thromb Res. 1994 Jun 1;74(5):487-93. doi: 10.1016/0049-3848(94)90269-0.
Plasma D-Dimer (DD), a highly sensitive marker of venous thromboembolism, was measured with an ELISA assay preoperatively and on the 12th postoperative day in 173 patients undergoing major hip surgery (78 elective arthroplasties and 95 operations for fractures). Proximal deep venous thrombosis (DVT) was detected by systematic compression venous ultrasonography on the 12th postoperative day in 12 (7%) patients. In one additional case, proximal DVT was diagnosed by venography. Preoperative DD level was significantly higher in patients with fracture than in patients undergoing elective arthroplasty. At a cutoff of 500 micrograms/L as determined by ROC curve analysis, the sensitivity, specificity, positive and negative predictive values of the pre-operative DD concentration for the development of subsequent proximal DVT were 93%, 23%, 36% and 96%, respectively. The diagnostic exclusion value of the DD measurement on the 12th postoperative day was similar but for a cutoff of 2000 micrograms/L. These data suggest that plasma DD measurement might be useful to predict and diagnose proximal DVT following major hip surgery.
血浆D - 二聚体（DD）是静脉血栓栓塞的一种高敏标志物，对173例行大髋关节手术的患者（78例择期关节成形术和95例骨折手术）在术前及术后第12天采用酶联免疫吸附测定法进行检测。术后第12天通过系统性压迫静脉超声检查在12例（7%）患者中检测到近端深静脉血栓形成（DVT）。另外1例近端DVT通过静脉造影确诊。骨折患者术前DD水平显著高于择期关节成形术患者。根据ROC曲线分析确定临界值为500微克/升时，术前DD浓度对随后发生近端DVT的敏感性、特异性、阳性预测值和阴性预测值分别为93%、23%、36%和96%。术后第12天DD测量的诊断排除值相似，但临界值为2000微克/升。这些数据表明，血浆DD测量可能有助于预测和诊断大髋关节手术后的近端DVT。
