老年下肢深静脉血栓患者D-二聚体的临界值研究

目的探讨老年患者血浆D-二聚体(DD)水平预测下肢深静脉血栓(DVT)的临界值。方法选择年龄≥60岁的住院患者394例,根据是否合并DVT,分为非DVT组235例和DVT组159例,DVT组60～79岁81例和≥80岁78例。住院期间,每隔1～2周进行血浆DD检查,对DD≥0.5mg/L的患者,即行下肢静脉血管超声检查,每隔3～5d进行超声复查,且DD检测时间缩短为每隔3～5d。结果与非DVT组比较,DVT组DD水平明显升高(P<0.01)。≥80岁患者DD水平较60～79岁患者明显升高(P<0.01);2个年龄段患者DD各临界值诊断下肢DVT的敏感性、特异性、阳性预测值及阴性预测值差异较大。结论将60～79岁患者预测下肢DVT的DD临界值定为0.5mg/L,≥80岁患者DD临界值定为2.0mg/L有临床指导意义。

Cut-off value of D-dimer in elderly patients with lower extremity deep venous thrombosis

Objective To study the cut-off value of plasma D-dimer(DD) level in elderly patients with lower extremity deep vein thrombosis(DVT).Methods Three hundred and ninety-four hospitalized patients with their age ≥60 years were divided into non-DVT group(n=235) and DVT group(n=159).Patients in the DVT group were further divided into 60-79 years old group(n=81)and ≥ 80 years old group(n=78).Their DD level was measured every 1-2 weeks.Those with their DD level higher than 0.5 mg/L underwent ultrasonography of lower extremity DVT every 3-5 days.Results The DD level was significantly higher in DVT group than in non-DVT group and in ≥ 80 years old group than in 60-79 years old group(P<0.01).The sensitivity,specificity,positive and negative predicting value of DD cut-off values were significantly different between the 60-79 years old group and ≥80 years old group.Conclusion The DD cut-off value is 0.5 mg/L and 2.0 mg/L,respectively,for the diagnosis of lower extremity DVT in 60-79 years old patients and ≥ 80 year old patients.