静脉血栓的诊断和预防中的D-Dimers:最近的进展及其实际影响
Benilde Cosmi1, Cristina Legnani2, Alessia Libra3
1Angiology and Blood Coagulation Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Angiology and Blood Coagulation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. benilde.cosmi@unibo.it
Polish archives of internal medicine
|November 15, 2023
概括
在低风险患者中,D-二聚体检测有助于排除静脉血栓塞栓症 (VTE). 调整D-二次离子切断值可以提高准确性,并且水平可以预测COVID-19的严重程度和复发性VTE风险.
科学领域:
- 生物化学 生物化学
- 血液学 血液学 血液学
- 临床诊断 临床诊断 临床诊断
背景情况:
- D-二次体是凝血和纤维溶解系统激活的标志物,由纤维素降解引起.
- 目前的指导方针建议在低或中等预试验概率 (PTP) 的患者中进行D-二聚体检测,以排除静脉血栓栓塞 (VTE) 的可能性.
- D-二聚合物测定具有高灵敏度但低特异性,其水平受到除血栓形成之外的因素的影响,包括年龄.
研究的目的:
- 探索D-二次体水平在诊断和管理各种临床疾病中的实用性.
- 调查改善D-二聚体检测的诊断准确性的方法.
- 评估D-二次体在预测COVID-19严重程度和复发性VTE中的作用.
主要方法:
- 基于PTP和确定的值,对D-二聚体在VTE排除中的作用进行审查.
- 根据患者特征 (年龄,PTP,怀孕,功能,癌症) 调整D-二次元切断的建议进行分析.
- 检查D-dimer与COVID-19严重程度的相关性及其在复发性VTE预测模型中的使用.
主要成果:
- D-二聚合物水平可以预测COVID-19患者的临床严重程度.
- 根据患者的因素调整D-二次元切断值可以提高诊断准确度.
- D-二聚合物水平被整合到用于预测复发性VTE的模型中,指导长期抗凝决定.
结论:
- 对于排斥VTE而言,D-二聚体测试是有价值的,特别是当PTP低到中等时.
- 个性化的D-二次元切断调整对于提高诊断特异性至关重要.
- 在COVID-19和VTE复发风险分层中,D-二次数水平提供了预后价值.
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