D-二聚体在鉴别急性主动脉夹层和其他急性胸痛中的价值被引量：8

Value of D-dimer in differentiating acute dissection from other causes of acute chest pain

下载PDF

导出

摘要目的探讨血D-二聚体浓度在急性主动脉夹层(acute aortic dissection,AAD)中的诊断价值。方法选取2016年6月至2017年6月因急性胸痛于24 h内就诊于海南省三亚市第三人民医院,并经计算机断层扫描血管造影(computerized tomographic angiography,CTA)检查确诊为AAD的患者41例,同时纳入以类似症状就诊的非AAD患者共40例作为对照组。比较AAD组与非AAD对照组血浆D-二聚体浓度,分析其在诊断急性主动脉夹层中的价值。结果 AAD组血浆D-二聚体浓度明显高于对照组,差异有统计学意义[(5.48±0.92)μg/mL vs.(0.66±0.11)μg/mL,P<0.05]。根据约登指数判断D-二聚体在0.765μg/mL时诊断AAD的敏感性(75.6%)、特异性较高(87.5%),受试者工作特征曲线(receiver operating characteristic curve,ROC)下面积为0.832,95%可信区间为0.740~0.923。结论本研究结果显示D-二聚体在诊断AAD中具有重要价值。 Objectives To evaluate the diagnostic value of D-dimer in acute aortic dissection(AAD).Methods A total of 81 patients with acute chest pain within 24 h were enrolled from June 2016 to June 2017,among them there were 41 patients diagnosed of AAD by computerized tomographic angiography(CTA),and 40 matched control patients with similar symptom but diagnosed of non-AAD were also enrolled.Concentration of D-dimer was compared between the two groups and diagnostic value of D-dimer in AAD was also detected.Results Plasma concentration of D-dimer was significantly higher in AAD group than that in control group[(5.48±0.92)μg/mL vs.(0.66±0.11)μg/mL,P<0.05].Receiver operating characteristic(ROC)curve analysis and Youden index showed that plasma concentration of D-dimer over 0.765μg/mL was predictive in the diagnosis of AAD,with 75.6%sensitivity and 87.5%specificity.The area under ROC curve was 0.832,95%CI was 0.740-0.923.Conclusions The present study shows that D-dimer played an important role in the diagnosis of AAD.

作者尹涛源林玲杨大英杜永才彭兴孙加凤 YIN Tao-yuan;LIN Ling;YANG Da-ying;DU Yong-cai;PENG Xing;SUN Jia-feng(Internal Medicine-Cardiovascular Department,The Third People′s Hospital of Sanya City,Sanya 572000,China;Department of Endocrinology,The Third People′s Hospital of Sanya City,Sanya 572000,China)

机构地区海南省三亚市第三人民医院心血管内科海南省三亚市第三人民医院内分泌科

出处《岭南心血管病杂志》 2018年第4期426-428,468,共4页 South China Journal of Cardiovascular Diseases

关键词主动脉夹层 D-二聚体诊断 aortic dissection D-dimer diagnosis

分类号 R543.16 [医药卫生—心血管疾病]

引文网络
相关文献

参考文献1

1姚晨玲,黄培志,童朝阳,顾国嵘,陈斌,顾俭勇,杨小亮,邓至,李鑫,郦珊珊.D-二聚体在急性主动脉夹层中的诊断价值[J].中华急诊医学杂志,2009,18(12):1309-1312. 被引量：27

二级参考文献15

1Meszaros I, Morocz J, Szlavi J, et al. Epidemiology and clinicopathology of aortic dissection[J]. Chest, 2000, 117(5) : 1271-1278.
2Erbel R, Alfonso F, Boileau C, et al. Diagnosis and management of aortic dissection[J]. Eur Heart J, 2001, 22(18): 1642-1681.
3Erbel R, Oelert H, Meyer J, et al. Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography. Implications for prognosis and therapy. The European cooperative study group on echecardiography [ J]. Circulation, 1993,87(5) : 1604-1615.
4Brown MD, Rowe BH, Reeves M J, et al. The aeeuraey of the enzymelinked immunosorbent assay D-dimer test in the diagnosis of pulmonary embolism: a meta-analysis [ J ]. Ann Emerg Meal, 2002, 40 ( 2 ) : 133- 144.
5Akutsu K, Sato N, Yamamoto T, et al. A rapid bedside D-dimer assay (Cardiac D-dimer)for screening of clinically suspected acute aortic dissection[J] .Circ J, 2005, 69(4):397-403.
6Perez A, Abbet P, Drescher MJ. D-Dimers in the emergency department evaluation of aortic dissection[J]. Acad Emer Med ,2004, 11 (4) : 397-400.
7Weber T, Hogler S, Auer J. D-dimer in acute aortic dissection [ J ].Chest,2003, 123(5) : 1375-1378.
8Ohlmann P, Faure A, Morel O, et al. Diagnostic and prognostic value of circulating D-Dimers in patients with acute aortic dissection[J]. Crit Care Med,2006, 34(5) : 1358-1364.
9Patrick O, Antoine F, Olivier M, et al. Diagnostic and prognostic value of circulating D-Dimer in patients with acute aortic dissection[J]. Crit Care Med,2006, 34(15) : 1358-1364.
10Suzuki T, Katoh H, Tsuchio Y, et al. Diagnnstie implications of ele- vated levels of smooth-muscle myosin Heavy-chain protein in acute aortic dissection[J]. Ann Intern Med,2000, 133(7):537-541.