DTT在D-二聚体假性增高病例中的应用

Application of DTT in cases with D-dimer pseudo elevation

目的探讨二硫苏糖醇(DTT)对19例血浆D-二聚体水平>纤维蛋白(原)降解产物(FDP)水平患者D-二聚体异常结果的纠正情况。方法选择2022年1月至2023年3月于该院就诊且首次出现血浆D-二聚体水平>FDP水平的19例患者标本作为试验组,分别采用稀释试验、比对试验确定是否为D-二聚体假性增高。同时随机选取20例FDP与D-二聚体比值为2~5的枸橼酸钠1∶9抗凝血浆作为对照组,将试验组和对照组分别进行DTT纠正试验和盐水处理试验,并对相关数据进行分析。结果随着稀释倍数的增加,19例患者D-二聚体水平呈下降趋势(P<0.05),FDP无显著性变化(P>0.05)。更换系统检测,19例均能纠正为FDP水平>D-二聚体水平。对照组经DTT处理后,与盐水处理比较,D-二聚体水平差异无统计学意义(P>0.05)。试验组的DTT处理和盐水处理结果比较,差异有统计学意义(P<0.05)。15例患者经DTT处理后,可纠正为FDP水平>D-二聚体水平,且DTT纠正后结果和比对系统结果比较,差异无统计学意义(P>0.05)。结论该研究中大部分D-二聚体假性增高者经DTT预处理后可纠正,且纠正后结果与比对系统结果具有一致性。

Objective To investigate the situation of dithithreitol(DTT)in correcting the D-dimer abnormal results in 19 patients with plasma D-dimer level>fibrin and fibrinogen degradation product(FDP)level.Methods The specimens of 19 patients who firstly appeared plasma D-dimer level>FDP level visited in this hospital from January 2022 to March 2023 were collected as the experimental group,and were tested by dilution and comparison tests to determine whether being D-dimer pseudo elevation.Meanwhile,20 cases of 1∶9 sodium citrate anticoagulated plasma with FDP/D-dimer ratio of 2-5 were randomly selected as the control group,the DTT correction test and normal saline treatment test were performed on both the experimental group and control group,then the related data conducted the analysis.Results As the dilution multiple increase,the D-dimer levels in the 19 cases showed the decreasing trend(P<0.05),while FDP had no significant change(P>0.05).By changing the system detection,all 19 cases could be corrected as the FDP level>D-dimer level.After the DTT treatment in the control group,there was no statistically significant change in the D-dimer level compared to saline treatment(P>0.05).In the experimental group,there was statistically significant differences between the DTT treatment results and saline treatment results.After the DTT treatment,15 cases were corrected as the FDP level>D-dimer level,moreover there was no statistical difference between the DTT corrected results and the comparison system results(P>0.05).Conclusion In this study,most individuals of the D-dimer pseudo elevation can be corrected after the DTT pretreatment,showing consistency between the corrected results and those of the comparison system.