D-二聚体测定在肺栓塞诊断中的应用价值

目的 探讨全自动免疫分析系统（VIDAS）快速定量检测D－二聚体（DD）在诊断肺栓塞中的临床价值。方法 使用VIDAS DD测定法对可疑静脉血栓塞患者血浆中纤维蛋白降解产物D－二聚体进行检测，并对这些可疑肺栓塞患者进行3个月的随访，了解是否有肺栓塞或深部静脉栓塞的症状。结果 共有104例患者参加检测，32例患者（30.8%）的D－二聚体检测值＜494ng/ml，72例患者血浆中的D－二聚体检测值＞494ng/ml，其中有16例患者通过肺通气－灌注扫描（V／Q）证实为肺栓塞。VIDAS DD法的敏感性为100％，阴性预期值为100％。结论 VIDAS DD法可作为排除诊断肺栓塞的首选筛选试验，可在临床诊断中推广应用。

A rapid quantitative ELISA for measuring D-dimer to exclude pulmonary embolism

Objective To study VIDAS D Dimer whether this new assay fulfill the requirements for diagnostic exclusion in patients suspected of pulmonary embolism. Methods Plasma D dimer of clinically suspected pulmonary embolism patients were measured by VIDAS D Dimer, three month after their inclusion all patients were confirmed to know if they had any new symptoms suggestive of deep vein thrombosis or pulmonary embolism. Results Among 104 suspected pulmonary embolism patients, 32 patients (30.8%) with DD levels <494 ng/ml and 72 patients with DD levels >494 ng/ml. 16 patients were confirmed with pulmonary embolism by V/Q scan , everyone of them with DD levels >494 ng/ml. The test showed a sensitivity of 100%, a negative predictive vale of 100%. Conclusion VIDAS D dimer is well sited as diagnostic tool for the exclusion pulmonary embolism.