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疑似深静脉血栓形成患者的血浆D - 二聚体检测——一种避免不必要静脉造影的方法

Plasma D-dimer measurement in patients with suspected DVT--a means of avoiding unnecessary venography.

作者信息

Khaira H S, Mann J

机构信息

Department of Haematology, Good Hope Hospital NHS Trust, Sutton Coldfield, West Midlands.

出版信息

Eur J Vasc Endovasc Surg. 1998 Mar;15(3):235-8. doi: 10.1016/s1078-5884(98)80182-2.

Abstract

OBJECTIVES

To assess the applicability of plasma D-dimer levels in the exclusion of a DVT.

DESIGN

Consecutive cohort of patients.

MATERIALS AND METHODS

Eighty consecutive patients presenting to the radiology department with a clinical diagnosis of DVT were included. Citrated blood samples were taken from all patients before radiological investigation, plasma isolated and frozen for subsequent testing. The patients then underwent venography (duplex scan was also used in some cases). Plasma samples were tested using the NycoCard D-Dimer. NycoCard Reader was used to estimate the D-dimer concentrations.

RESULTS

A DVT was diagnosed in 29 cases (36.7%). Plasma D-dimer levels had a sensitivity of 96% (only one false negative), specificity of 40%, positive predictive value of 48%, and negative predictive value of 95% when compared to venography.

CONCLUSIONS

A normal plasma D-dimer level could be used as an exclusion test for DVT avoiding complications of venography and saving time and money.

摘要

目的

评估血浆D-二聚体水平在排除深静脉血栓形成(DVT)中的适用性。

设计

连续队列研究患者。

材料与方法

纳入80例连续就诊于放射科且临床诊断为DVT的患者。在进行放射学检查前,采集所有患者的枸橼酸盐抗凝血样本,分离血浆并冷冻以备后续检测。然后患者接受静脉造影检查(部分病例也使用了双功扫描)。使用NycoCard D-二聚体检测血浆样本。用NycoCard Reader估算D-二聚体浓度。

结果

29例(36.7%)诊断为DVT。与静脉造影相比,血浆D-二聚体水平的敏感性为96%(仅1例假阴性),特异性为40%,阳性预测值为48%,阴性预测值为95%。

结论

正常的血浆D-二聚体水平可作为DVT的排除试验,避免静脉造影的并发症,节省时间和费用。

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