D-dimer与纤维蛋白原比值在静脉血栓栓塞诊断中的应用价值

The Clinical Evaluation of the D-dimer Fibrinogen ratio in the Diagnosis of Venous Thromboembolism

目的探讨D-dimer、纤维蛋白原(Fg)、D-dimer与Fg比值(D/F)以及C反应蛋白(CRP)在静脉血栓栓塞(VTE)中的临床诊断价值。方法对民航总医院就诊的221例急诊与住院疑似VTE患者D-dimer、Fg及CRP进行检测,并计算D/F,采用胸部CT、病理诊断等对疑似患者明确诊断。结果 VTE人群的Fg水平低于非VTE人群(t=6.421,P<0.01),而D-dimer、D/F、CRP均显著增高;在VTE诊断灵敏度达到100%时,D/F特异度与阳性预测值(PPV)(73.2%,56.4%)优于使用单独使用D-dimer(47.0%,39.6%);ROC曲线分析表明上述指标在VTE诊断中的准确性顺序为D/F>D-dimer>CRP。结论采用D/F可提高VTE临床诊断的特异性,可作为一项有益的指标应用于VTE辅助诊断。

Objective to investigate the clinical value of D-dimer Fibrinogen ratio（D/F）in the diagnosis of Venous Thromboembolism（VTE）.Methods 221 patients with suspected VTE entered the present study,whose blood samples were collected for the analysis of D-dimer,fibrinogen（Fg） and C-reactive protein（CRP）.Results the levels of Fg in VTE patients were decreased by comparison with those in non-VTE（t=6.421,P0.01）,while the D-dimer and CRP levels were higher than those in non-VTE.When the diagnostic sensitivity of VTE reached 100%,the diagnostic specificity and PPV（73.2%,56.4% respectively） of D/F were higher than D-dimer（47.0%,40.0% respectively）;Finally,ROC indicated that the diagnostic accuracy of the relative indices was in sequence of D/F D-dimer CRP.Conclusion The D/F could improve the specificity in VTE prognosis and should be taken as a valuable supplemental biomarker in the screening and diagnosis of VTE.