退出旧,进入新:与年龄相关的D-Dimer值
Ciara O'Connor1,2, Claire McIntyre1, Claire Wynne2
1Pathology Laboratory Department, Blackrock Health Hermitage Clinic, Dublin, Ireland.
International journal of laboratory hematology
|December 4, 2025
概括
使用年龄调整的D-二次数值可以显著减少静脉血栓塞栓症 (VTE) 诊断中的错误阳性,特别是在老年人中. 这种方法提高了诊断的准确性,并尽量减少不必要的成像程序.
科学领域:
- 血液学 血液学 血液学
- 临床诊断 临床诊断 临床诊断
- 医学研究 医学研究
背景情况:
- 布莱克罗克医疗中心 (Blackrock Health Hermitage Clinic,简称BHHC) 目前的做法是使用固定的D-二次数值 (0.500μg/mL),与不断变化的国际准则相背离,偏好年龄调整的切断值.
- 在所有临床领域都注意到对静脉血栓塞栓症 (VTE) 查和诊断缺乏一致的政策遵守.
- 根据年龄调整的D-二分体值,结合临床概率评估,显示出潜在的降低不必要的诊断成像和测试VTE.
研究的目的:
- 评估BHHC患者群体中年龄调整的D-二次数切断值的适当性.
- 评估实施年龄调整的D-二次数值对诊断准确度和资源利用的影响.
- 讨论将年龄调整的值与VTE诊断的临床概率工具相结合的好处.
主要方法:
- 进行了一项横截面研究,以确定与年龄相关的D-二次元值.
- 使用ACLTOP 350分析仪测量D-二极体水平,使用HemosIL D-二极体HS 500试剂.
- 使用IBM SPSS v29和Microsoft Excel进行统计分析,得到了BHHC临床治理委员会的道德批准.
主要成果:
- 在年龄和D-二次体水平之间观察到正相关性.
- 实施年龄调整的值 (年龄×0.01μg/mL对于50岁以上的个体) 在研究年龄组中减少了12.6%的假阳性结果.
- 这种调整提高了D-二聚体检测对VTE检测的特异性.
结论:
- 建议对年龄进行调整的D-二次数值用于VTE诊断,特别是当与威尔斯得分等验证的临床概率工具一起使用时.
- 这种综合方法提高了诊断特异性,从而减少了不必要的成像,特别是在老年患者中.
- 这些发现支持采用年龄调整的D-二次数值,以优化临床实践中VTE诊断策略.
更多相关视频
相关概念视频
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
382
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
382
Pharmacodynamics in Geriatric Patients: Effects of Age
367
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
367
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
469
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
469


