D-二聚体和残余血栓与静脉血栓再发关系的Meta分析

Meta Analysis:Relationship between High Concentrations of D-dimer,Residual Venous Thrombosis and the Recurrence of Venous Thromboembolism

目的系统评价静脉血栓栓塞症患者停用维生素K拮抗剂后高浓度D-二聚体(>500 ng/ml)和残余血栓与静脉血栓再发的关系。方法采用Meta分析专用软件Review Manager 5.0,对国外7篇关于高浓度D-二聚体和残余血栓与静脉血栓再发关系的相关文献的研究结果进行Meta分析。结果 D-二聚体水平增高组的静脉血栓再发率明显高于D-二聚体水平正常的对照组(P<0.00001);有残余血栓组与无残余血栓组间的静脉血栓再发率无显著性差异(P>0.05)。结论在停止抗凝治疗1个月后,D-二聚体浓度>500 ng/ml与静脉血栓再发的危险性相关,而残余静脉血栓与静脉血栓再发的危险性无关。

Objective To systematically evaluate the relationship between high D-dimer concentrations,residual venous thrombosis and recurrent venous thromboembolism after withdraw of vitamin K antagonist.Methods The results of 7 studies on relationship between high concentrations of D-dimer,residual venous thrombosis and recurrence of venous thromboembolism were meta-analyzed using Review Manager 5.0.Results Recurrence rate in the D-dimer-elevated group was higher than in the control group with normal D-dimer concentrations（P0.00001）;no significant difference in recurrence rate between the residual venous thrombosis group and the control group without residual venous thrombosis were noted（P0.05）.Conclusion One month after vitamin K antagonist withdrawn,D-dimer concentration（ 500 ng/ml） is correlated with higher risk of recurrent venous thromboembolism,while the presence of residual venous thrombosis is not correlated with the risk of thromboembolism recurrence.