Horney E, Lagerstedt C
medicinkliniken, Blekingesjukhuset, Karlshamn.
Lakartidningen. 1998 Jan 7;95(1-2):55-8.
The reliability of D-dimer (NycoCard D-dimer) and CRP (C-reactive protein) tests to exclude suspected deep venous thrombosis (DVT) and pulmonary embolism (PE) was investigated in 116 patients. Venography, ultrasonography or ventilation-perfusion lung scanning was used as the control method in 95, 5, and 14 patients, respectively, and pulmonary angiography in two patients, one of whom also underwent lung scanning, the other venography. Of the 116 patients, 52 had thromboembolism (46 DVT and 6 PE). The respective sensitivity, specificity, and negative and positive predictive values (NPV, PPV) were 94%, 27%, 85% and 51% for the D-dimer test, and 80%, 53% 76% and 60% for the CRP test. As venous thromboembolism is a life-threatening condition, the NPV of an exclusion test must lie very close to 100 per cent, and thus the study showed neither the D-dimer nor the CRP test to be a satisfactory exclusion test for use in cases of suspected DVT or PE.
对116例患者进行了D-二聚体（NycoCard D-二聚体）和CRP（C反应蛋白）检测以排除疑似深静脉血栓形成（DVT）和肺栓塞（PE）的可靠性研究。分别有95例、5例和14例患者采用静脉造影、超声检查或通气-灌注肺扫描作为对照方法，2例患者采用肺血管造影，其中1例同时接受了肺扫描，另1例接受了静脉造影。116例患者中，52例有血栓栓塞（46例DVT和6例PE）。D-二聚体检测的敏感性、特异性、阴性预测值和阳性预测值（NPV、PPV）分别为94%、27%、85%和51%，CRP检测的分别为80%、53%、76%和60%。由于静脉血栓栓塞是一种危及生命的疾病，排除试验的NPV必须非常接近100%，因此该研究表明，D-二聚体和CRP检测均不是用于疑似DVT或PE病例的令人满意的排除试验。
