D-dimer Plus试剂在深静脉血栓形成早期中的评价

目的评价血浆D-dimer Plus试剂在诊断深静脉血栓(DVT)形成早期的临床筛查价值。方法采用D二聚体Plus试剂盒,分别对59例DVT患者和60例门诊健康体检者进行血浆D二聚体测定,并进行统计学t检验,ROC曲线分析和D二聚体在不同截断值情况下的筛检评价。结果 DVT组D二聚体(675±206μg/L)显著高于对照组(91±69μg/L),有显著的统计学意义(P=0.034);ROC曲线分析结果显示,D二聚体用于DVT临床诊断有显著统计学意义(AUC=0.706,P=0.000),D二聚体水平越高,发生DVT的可能性越大;以D二聚体水平为200μg/L为截断值时,其阴性预测值和临床诊断符合率都是最高的,分别为67.06%和73.95%。结论 D-dimer Plus试剂在DVT的早期临床诊断中价值有限,而对于疑似DVT患者,建议以200μg/L作为截断值。D二聚体水平并不升高的临床疑似DVT患者,需要进行连续监测与静脉影像学检查。

Clinical Diagnostic Value of D-dimer Plus Assay in Patients with Deep Vein Thrombosis

Objective To evaluate the diagnostic value of D-dimer Plus assay in patients with early deep vein thrombosis （DVT）. Methods The D-dimer level was detected in 59 patients with DVT and 60 healthy control subjects by using D-dimer Plus reagent. Results The D-dimer level was significantly higher in the case group than in the control group （ P = 0. 034） ; ROC curve analysis showed that D- dimer was a sig- nificant indicator for the clinical diagnosis of DVT, and the higher D- dimer level, the greater possibility of DVT. The negative predictive value and clinical diagnosis rate have the best performance under the cut-off val- ue of 200 μg/L. Conclusion We suggest that the cut- off value of 200 μg/L is more useful than 250 μg/L for excluding patients suspected with DVT. D- dimer Plus assay has a limited value in screening of DVT. For the patients with suspected DVT, it is necessary to screening D-dimer continuously, or to perform venous ima- glng