作为对大动脉剖析的排除规则的D-二次体
Jeremy M Carter1, Roshan B Tom1, Raheed Sunesra1
1Department of Emergency Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
Cureus
|January 8, 2024
概括
升高的D-二次体水平对于诊断急性大动脉解剖 (AAD) 是高度敏感的. 这一发现表明,D-二聚体测试可以帮助排除低风险患者的AAD,从而可能避免更具侵入性的诊断程序.
科学领域:
- 心血管医学 心血管医学
- 诊断成像 诊断成像 诊断成像
- 血液学 血液学 血液学
背景情况:
- 急性大动脉解剖 (AAD) 由于各种症状和与其他疾病重叠而带来诊断挑战.
- 目前的诊断工具,如CT和心声回声,并不总是可行的.
- 有限的研究存在于D-dimer的实用性,排除罕见的AAD.
研究的目的:
- 在诊断ADD时评估D-二次体水平升高的敏感性.
- 在大量患者队列中评估D-dimer的实用性.
- 为了确定D-二次体是否可以帮助排除疑似病例中的AAD.
主要方法:
- 对TrinetX数据库的回顾性分析,包括两十年来来自54个美国医疗保健组织的8500万患者.
- 在诊断后24小时内进行D-二聚体检测的1,319名确诊AAD患者的鉴定.
- 在400 ng/ml和500 ng/ml的切割值下评估D-二聚合物灵敏度.
主要成果:
- 400 ng/ml的D-二元切割值显示了AAD的0.949的灵敏度.
- 500 ng/ml的D-二聚合物切割值为AAD.产生了0.930的敏感性.
- 在1,319名AAD患者中,1,252人具有D-二次数>400ng/ml,1,227人具有D-二次数>500ng/ml.
结论:
- 升高的D-二次体水平对于诊断急性大动脉解剖 (AAD) 是高度敏感的.
- D-二次体测试显示,在排除AAD时具有显著的灵敏度.
- 这种生物标志物可能有助于避免在怀疑ADD的低风险患者中进行不必要的侵入性测试.
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