测量血中的D-二聚物作为疑似肺栓塞的诊断辅助
H Bounameaux1, P Cirafici, P de Moerloose
1Department of Medicine, University Hospital of Geneva, Switzerland.
Lancet (London, England)
|January 26, 1991
概括
血D-二聚体 (DD) 测试对于诊断肺栓塞 (PE) 是有价值的. 低于500微克/l的DD度有效排除了PE,有助于急诊诊断.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 血液学 血液学 血液学
- 心脏病学 心脏病学
背景情况:
- 肺栓塞 (PE) 诊断在紧急情况下可能具有挑战性.
- D-二聚合物 (DD) 是纤维素降解产物,在血栓事件中升高.
研究的目的:
- 评估血D-二聚合物 (DD) 水平对肺栓塞 (PE) 的诊断效用.
- 评估DD在排除PE在急诊室患者中的作用.
主要方法:
- 对171名连续急诊室患者的前性研究,他们怀疑PE.
- 通过临床评估,VQ肺部扫描和进一步的成像 (血管学,静脉学) 确定PE的诊断.
- 血DD度测量并与已确认的PE诊断相关.
主要成果:
- 肺栓塞 (PE) 在32%的患者中被诊断为肺栓塞.
- 500微克/升的D-二聚合物 (DD) 截止值显示PE的灵敏度为98%和特异性为39%.
- 负预测值为98%,DD低于500微克/l排除了PE.
- 在没有确的VQ扫描的患者中,在25%的病例中,DD测试可以避免进一步的程序.
- 在提出后的7天内,DD敏感性仍然很高 (96-93%).
结论:
- 血D-二次数 (DD) 测量是排除肺栓塞 (PE) 在急诊室环境中的一个有价值的工具.
- 500微克/升以下的度有效排除了PE,简化了诊断途径.
- DD测试可以减少进一步调查的需要,特别是在具有不确定的通风-输液扫描的患者中.
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