D-二聚体检测在深静脉血栓诊断中的临床价值

The Use of Plasma D-Dimer Level as a Screening Test In Deep Venous Thrombosis

[目的]调查中风恢复期病人血浆D-二聚体检测对于诊断深静脉血栓的特异性、阴性预测值以及经济性。[方法]用D-二聚体浊度法分析109例因近期局部出血或缺血导致的中风后恢复期患者血浆样本。病人在24h内血管彩色多普勒超声检查。[结果]血管彩色多普勒超声检查有5例患者有深静脉血栓形成。以500μg/L作为D-二聚体的cut-off值分类患者是否有深静脉血栓形成的敏感性100%,特异性89%,阳性预报值31%,阴性预报值100%。[结论]血浆D-二聚体含量测定在排除诊断深静脉血栓形成中有非常好的有效性以及可接受的特异性。

[Objective]This study investigated the utility of plasma D-dimer level as a diagnostic test for deep vein thrombosis (DVT)in patients for stroke rehabilitation.[Methods]Plasma samples were drawn from 109 nonambulatory rehabilitation patients recent ischemic or hemorrhagic stroke and assayed for D-dimer with D-Dimer PLUS method.Samples were drawn within 24 hours of venous duplex ultrasound(VDU)screening for DVT.[Results]Five of 105 patients had DVT identified by VDU scan.The op- timal cut point for predicting DVT was D-dimer 500μg/L,resulting in 100% sensitivity,89% specificity,31% positive predictive value,and 100% negative predictive value.[Conclusion]Plasma D-dimer level is a simple and inexpensive screening test for DVT during stroke rehabilitation.