D-二聚体诊断创伤后急性下肢深静脉血栓的临床意义

Clinical significance of D-dimer for diagnosing acute deep venous thrombosis of lower limb after trauma

目的估测D-二聚体诊断创伤后急性下肢深静脉血栓(DVT)的临界值,并进一步探讨其临床意义。方法回顾性分析362例创伤后急性DVT患者,并依据彩色多普勒超声诊断结果,分为血栓组(71例)和非血栓组(291例),记录两组D-二聚体含量,并应用统计软件绘制ROC曲线进行分析。结果 ROC曲线下面积为0.631,D-二聚体用于诊断下肢DVT最佳临界值为287 mg/L(敏感度为76.1%,特异度为52.6%,阳性似然比为1.61)。结论 D-二聚体对创伤后急性下肢DVT诊断准确性偏低,287 mg/L作为诊断创伤后急性下肢DVT的临界值较为合适。

Objective To determine the D-dimer the critical value in the diagnosis of acute deep vein thrombosis（DVT） after trauma,and further to explore its clinical significance.Methods 362 post-trauma out-patients and in-patients were divided into thrombosis group（71 cases） and non-thrombosis group（291 cases）,according to ultrasonic results.To record every patient′s D-dimer levels and draw a ROC curve.Results Area under ROC curve was 0.631,and the standard error was 0.033（P〈0.01）.The optimal critical value of D-dimer for acute DVT was 287 mg/L（sensitivity 76.1%,specificity 52.6%,positive likelihood ratio of 1.61）.Conclusion D-dimer test has some diagnostic value for acute DVT,but the accuracy is not high.While 287 mg/L is more appropriate as the critical value for acute DVT.