血清D-二聚体在急性主动脉夹层诊断价值的Meta分析

A Meta analysis of diagnostic value of serum D-dimer in acute aortic dissection

目的评估血清D-二聚体(DD)诊断急性主动脉夹层(AAD)的灵敏度和特异度。方法使用aortic、dissection和D-dimer三个关键词全面检索英文数据库。采用MS Excel 2003、ReviewManager 5.1、STATA 12和Meta-DiSc 1.4进行数据管理、计算和统计分析。结果最终共纳入9个研究,包括532例AAD患者和780例健康对照者。DD临界值取500ng/ml时,综合灵敏度、特异度及其95%可信区间分别为0.97[0.94-0.98]、0.61[0.53-0.69]。结论 DD可作为排除AAD的血清学指标。若DD水平小于500ng/ml,对于非高危患者,则无需行进一步检查。

Objective To evaluate the sensitivity and specificity of serum D-dimer（DD） assay for diagnosing acute aortic dissection（AAD）.Methods The key words of aortic,dissection and D-dimer were used to search all English databases.Data management,calculation and statistics were analyzed by MS Excel 2003,Review Manager 5.1,STATA 12and Meta-DiSc 1.4.Results A total of 532 patients with AAD and 780 healthy people from nine studies was finally included.Taking 500ng / ml as a cutoff DD value,the sensitivity and specificity with their 95%confidence intervals were 0.97 [0.94-0.98] and 0.61 [0.53-0.69],respectively.Conclusion Serum DD may be taken as a serologic marker for excluding the diagnosis of AAD.If DD is less than 500ng/ml,there is no need for further inspection in the patients without high risk.