Sassa H, Sone T, Tsuboi H, Kondo J, Yabashi T
Department of Cardiology, Ogaki Municipal Hospital, Japan.
Jpn Circ J. 1996 Apr;60(4):201-6. doi: 10.1253/jcj.60.201.
Thrombin-antithrombin III (TAT) and D-dimer were measured in 50 patients suspected of deep venous thrombosis (DVT) to assess the usefulness of these indicators in the diagnosis of DVT. DVT was diagnosed by ultrasonography (compression method and Doppler imaging). In patients who were negative for DVT (Group A), TAT was 3.8 +/- 2.36 micrograms/L (mean +/- SD) and D-dimer was 0.7 +/- 0.69 micrograms/ml, whereas in patients diagnosed with DVT (Group B), TAT was 20.4 +/- 19.10 micrograms/L (p < 0.001) and D-dimer was 9.0 +/- 9.21 micrograms/ml (p < 0.001). Thus, Group B had significantly higher levels of both markers. Moreover, 19 of the 23 cases in Group B had acute DVT, with symptoms appearing within 2 weeks of onset. When the cutoff for a positive diagnosis of DVT was set at TAT of 7.0 micrograms/L or more and D-dimer of 3.0 micrograms/ml or more, sensitivity was 84%, specificity was 96%, and accuracy was 90%. Based on these results, we concluded that TAT and D-dimer are extremely useful in screening for acute DVT.
对50例疑似深静脉血栓形成（DVT）的患者测定了凝血酶 - 抗凝血酶III（TAT）和D - 二聚体，以评估这些指标在DVT诊断中的有用性。通过超声检查（压迫法和多普勒成像）诊断DVT。在DVT阴性的患者（A组）中，TAT为3.8±2.36微克/升（平均值±标准差），D - 二聚体为0.7±0.69微克/毫升，而在诊断为DVT的患者（B组）中，TAT为20.4±19.10微克/升（p<0.001），D - 二聚体为9.0±9.21微克/毫升（p<0.001）。因此，B组两种标志物的水平均显著更高。此外，B组23例中有19例为急性DVT，症状在发病后2周内出现。当DVT阳性诊断的临界值设定为TAT 7.0微克/升或更高且D - 二聚体3.0微克/毫升或更高时，敏感性为84%，特异性为96%，准确性为90%。基于这些结果，我们得出结论，TAT和D - 二聚体在急性DVT筛查中极其有用。
