根据年龄调整和临床概率调整的D-Dimer截止值来排除肺栓塞:临床试验的叙述性综述
Marc Righini1, Helia Robert-Ebadi1, Grégoire Le Gal2,3
1Division of Angiology and Hemostasis, Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland.
Journal of clinical medicine
|June 27, 2024
概括
诊断肺栓塞 (PE) 是一个挑战. 调整后的D-二次离子切断提高了诊断效率,但安全性和效率因患者患病率和临床环境而异.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
背景情况:
- 肺栓塞 (PE) 诊断是复杂的,因为广泛的差异诊断.
- 连续诊断策略包括临床概率,D-二次体测试和CT肺血管造影验证.
- 500μg/L的标准D-二极管切断值在20-30%的疑似病例中有效排除了PE.
研究的目的:
- 评估提高PE诊断中的D-二次体试验效率的方法.
- 为了比较年龄调整与临床概率调整的D-二次数切断的安全性和效率.
- 分析PE流行率和临床环境对D-二次元切断性能的影响.
主要方法:
- 对验证PE顺序诊断策略的前性结果研究的审查.
- 对年龄调整的D-二次元切断策略的分析.
- 对临床概率调整的D-二分体切断策略的分析.
- 检查影响D-二分体切断性能的外部因素,包括疾病流行率和临床环境.
主要成果:
- 根据年龄调整的D-二次元切断似乎更安全但效率较低.
- 根据临床概率调整的D-二分体切断似乎更有效,但不那么安全.
- 疾病患病率和临床环境显著影响了调整/适应截止值的负预测值和效率.
结论:
- 根据年龄调整和临床概率调整的D-二次元切断线都比标准切断线提供了更好的诊断产量.
- 切断策略的选择应考虑预期的PE患病率和特定的临床环境.
- 优化D-二元策略需要平衡诊断效率与患者安全.
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