D-二聚体在静脉血栓栓塞症中的应用

血浆D-二聚体是纤溶酶水解交联纤维蛋白形成的降解产物之一,为继发性纤溶特有的代谢物,由于其高敏感性,血浆D-二聚体检测被广泛地应用于排除可疑性静脉血栓栓塞症(VTE),包括下肢深静脉血栓形成及肺栓塞。但由于其特异性不高,常需与临床概率评估、下肢静脉加压超声、CT及静脉造影等联合用于VTE的诊断。该文就D-二聚体的检测方法、用于排除VTE、诊断VTE、在特殊人群中的应用进行综述。

D-dimer for Venous Thromboembolism

Plasma D-dimer（DD） is one of the degradation products of the cross-linkod fibrin hydrolyzed by fibrinolysin and is also a unique metabolite of secondary fibrolysis. Due to its high sensitivity,it is particu- larly useful in the excluding of suspected venous thromboembolism （ VTE ） population, which includes deep venous thrombosis（DVT） and pulmonary embolism（PE）. Due to its poor specificity precluding its use for ruling in VTE, DD testing must be integrated in comprehensive, sequential diagnostic strategies that include clinical probability assessment and lower limb venous compression ultrasonography, CT and venography. Here is to make a review of the DD test method, DD application in the ruling nut VTE, diagnosis of clinically suspected VTE and special populations etc.