平均血小板体积和D-D测定在疑似深静脉血栓患者中的应用

Application of Mean Platelet Volume and D-dimer in Patients with Suspected Deep Venous Thrombosis

目的:通过测定分析急性深静脉血栓栓塞(DVT)患者的平均血小板体积(MPV)和D-二聚体(D-D)水平,旨在探讨联合使用该两项目在急性DVT中的诊断价值。方法:采集72例疑似急性DVT患者的血液,测定MPV和D-D。结果:15例经双联超声检查确诊为急性DVT患者的MPV(13.0±1.56)fl显著高于非急性DVT患者MPV(8.76±1.07)fl(P<0.01)。而且D-D结果亦显著高于非DVT患者(P<0.01)。取MPV阈值为11.0fl时,MPV诊断灵敏度为71.3%,特异性为38.6%;取D-D阈值为0.5mg/L时,诊断灵敏度96.2%,特异性32.7%;当联合应用MPV和D-D时,诊断特异性上升到71.2%。结论:测定结果提示,MPV升高与急性DVT有关,MPV升高可增加D-D对急性DVT的诊断特异性。

Objective To analyse the diagnostic value of mean platelet volume （MPV） and D-dimer for acute deep venous thromboembolism （DVT）. Methods 72 patients with suspected lower limb DVT were recruited. Plasma levels of MPV and D-dimer were detected. Results MPV of patients with acute DVT diagnosed by duplex ultrasonography was significantly higher than that of pa- tients withour DVT （P 〈0.01 ）. The mean MPV was 13.0 ± 1.56fl and 8.76 ±1.07fl in patients with DVT and without DVT, respec- tively. D-dimer also presented remarkably higher in patients with DVT （P 〈0.01 ）. For all the patients, a positive MPV when the cut- off value was 11. Off, had 71.3% sensitivity and 38.6% specificity, discretely D-dimer （with a cut-off value of 0.5mg/L）had 96.2% sensitivity and 32.7 % specificity, separately. In case of combination of MPV and D-dimer, the diagnostic specificity reached 71.2%. Conclusion The results indicated that elevated MPV was found to be associated with acute DVT and high levels of MPV might in-crease the diagnostic specificity of D-dimer for exclusion of DVT.