D-二聚体检测及临床应用研究

Research on D-dimer Detection and Clinical Application

D-二聚体是可溶的纤维蛋白降解产物,是由纤维蛋白溶解系统对血栓的有序分解产物,是临床凝血和纤溶激活的重要检测指标。因D-二聚体检测具有高度敏感性和阴性预测能力,使其在临床静脉血栓形成、弥漫性血管内凝血、急性冠脉综合征等疾病的鉴别诊断和治疗监测方面得到广泛应用。但D-二聚体检测多样化,不同检测方法检测结果存在差异;且D-二聚体表达水平受个体差异影响,一定程度限制了D-二聚体在临床的应用。本文主要就D-二聚体的形成机制、检测方法以及在临床的应用进行综述,以期为D-二聚体检测的合理应用提供参考依据。

D-dimer is a soluble fibrin degradation product,which is an orderly decomposition product of thrombus by fibrinolysis system.It is an important detection index of clinical coagulation and fibrinolysis activation.Because of its high sensitivity and negative predictive ability,D-dimer detection has been widely used in the differential diagnosis and treatment monitoring of clinical venous thrombosis,diffuse intravascular coagulation,acute coronary syndrome and other diseases.However,the detection of D-dimer is diversified,and the results of different detection methods are different.The expression level of D-dimer is affected by individual differences,which limits the clinical application of D-dimer to a certain extent.This article mainly reviews the formation mechanism,detection methods and clinical application of D-dimer,in order to provide reference for the rational application of D-dimer detection.