茂名地区中老年人血浆D-二聚体参考区间的建立及应用评估

The plasma D-Dimer reference range establishment and the evaluation in the middle-aged and elderly of Maoming Area

目的：建立并了解中老年人血浆D-二聚体的参考区间，提高血浆D-二聚体在中老年人患者中的应用价值。方法选取2012年10月~2014年11月广州中医药大学附属茂名市中医院内科健康体检的50岁以上中老年人685名（男411名，女274名），发生肺栓塞5例，静脉血栓症4例及健康青年对照组164名。将50岁以上的中老年人按男、女及年龄分为50~＆lt;60岁组、60~＆lt;70岁组、70~＆lt;80岁组、≥80岁组。应用百分位数（P95）表示参考区间的单侧上限制订上侧界值。采用本研究建立的参考区间评估9例静脉血栓症或肺栓塞患者D-二聚体水平，以验证建立的参考区间的有效性。结果50岁以上中老年人不同年龄组D-二聚体水平差异有高度统计学意义（P〈0.01），同一年龄组内不同性别D-二聚体水平差异无统计学意义（P〉0.05）。D-二聚体参考区间随年龄而逐渐升高，各年龄段均高于健康人群的疾病界定值（0.5 mg/L）。采用上述参考区间评估9例患者的D-二聚体水平，均为阳性结果。结论本研究初步建立并评估了茂名地区50岁以上中老年人血浆D-二聚体参考区间，提高了D-二聚体检测在中老年人群中的应用价值。

Objective To establish and understand the plasmatic D-Dimer reference range in the middle-aged and el-derly, and improve the application value of D-Dimer in the middle-aged and elderly. Methods From Octorber 2012 to Novenber 2014, selected 685 old people aged over 50 years （male 411 cases, female 274 cases） who had joined the medicine health examination in Department of Internal Medicine, Maoming Traditional Chinese Medical Hospital Affili-ated to Guangzhou University of Traditional Chinese Medicine, and 5 patients with venous, 4 patients with venous throm-bosis and 164 healthy youths （as the control group）. The elderly aged over 50 years were divided into 50-〈60 years old group, 60-〈70 years old group, 70-〈80 years old group and≥80 years old group, by sex. The upper values （one-tailed） were established by using （P95） percentile method. Using the established reference range to access the D-Dimer level in 9 patients with venous thrombosis or the patients with pulmonary embolism, in order to verify the effectiveness of the reference intervals establishment. Results There was statistical significance in the D-Dimer level in different age groups （over 50 years old） （P〈0.01）, but no statistical significance in the same age group of different sex （P〉0.05）. With the age increasing, the diseased value of definition of all ages were higher than those in healthy population （0.5 mg/L）. Using the reference interval to evaluate the D-Dimer level of 9 patients, the results were positive. Conclusion This study es-tablishes and evaluates the plasma D-Dimer reference interval among the elderly aged over 50 years old in Maoming Area, and improves the application value of D-Dimer in the middle-aged and elderly.