Wildberger J E, Vorwerk D, Kilbinger M, Lentner A, Wienert V, Günther R W
Klinik für Radiologische Diagnostik, Universitätsklinikum, RWTH Aachen.
Rofo. 1997 Jul;167(1):79-82. doi: 10.1055/s-2007-1015495.
Evaluation of sensitivity and specificity of a bed-side test in the diagnosis of deep-vein thrombosis compared to contrast phlebography.
122 patients, referred for phlebography, underwent bedside testing (SimpliRED) for detection of deep vein thrombosis. Contrast phlebography was confirmed immediately afterwards. SimpliRED provides a clearly visible agglutination of the patient's red blood cells in the presence of elevated levels of crosslinked fibrin derivatives (D-dimer) in the sample, being specific for fibrin breakdown.
In 37 (30.3%) patients deep vein thrombosis could be confirmed. An abnormal D-dimer test was found in 35 of the 37 patients with thrombosis (sensitivity: 94.6%). Two patients who had not been identified by agglutinin testing, showed an isolated calf thrombosis in small muscle veins (< 2 cm in diameter) not requiring treatment. 55 of 85 patients without thrombosis in phlebography were stated correctly by SimpliRED (specificity: 64.7%).
All thrombotic disorders in the leg with the need for further treatment were identified correctly. SimpliRED is a very sensitive test with moderate specificity in the diagnosis of deep vein thrombosis. Therefore, further invasive testing is needed only in such patients where the D-dimer test is abnormal. A false positive result of the bed-side test may be non-specific or due to elevated levels of fibrin split products, if the coagulation system is activated in several other conditions.
与静脉造影术相比，评估一种床旁检测在诊断深静脉血栓形成中的敏感性和特异性。
122例被转诊进行静脉造影术的患者接受了用于检测深静脉血栓形成的床旁检测（SimpliRED）。随后立即进行静脉造影术确认。SimpliRED在样本中交联纤维蛋白衍生物（D - 二聚体）水平升高时会使患者红细胞出现明显可见的凝集，对纤维蛋白降解具有特异性。
37例（30.3%）患者被确诊为深静脉血栓形成。37例血栓形成患者中有35例D - 二聚体检测异常（敏感性：94.6%）。2例未通过凝集素检测识别出的患者，显示出孤立的小腿小肌肉静脉血栓形成（直径<2 cm），无需治疗。静脉造影术显示无血栓形成患者中的85例中有55例被SimpliRED正确判定（特异性：64.7%）。
所有需要进一步治疗的腿部血栓性疾病均被正确识别。SimpliRED在诊断深静脉血栓形成方面是一种敏感性很高但特异性中等的检测方法。因此，仅在D - 二聚体检测异常的患者中需要进一步进行侵入性检测。如果在其他几种情况下凝血系统被激活，床旁检测的假阳性结果可能是非特异性的或由于纤维蛋白裂解产物水平升高所致。
