血浆D-二聚体的测定在排除肺栓塞诊断中的临床意义

目的探讨D-二聚体(D-dimer,DD)在排除肺栓塞诊断中的临床价值。方法使用ELISA法对可疑肺栓塞患者血浆中纤维蛋白降解产物DD进行检测,并对这些可疑肺栓塞患者进行半年的随访,了解是否有肺栓塞或深静脉栓塞的症状。结果共有102例患者参加检测,42例患者(41.1%)的DD检测值<500μg/L,60例患者血浆中的DD检测值>500μg/L,其中有11例患者通过肺通气灌注扫描(V/Q)证实为肺栓塞。ELISADD法的敏感性为100%,阴性预期值为100%。结论DD检测方法简便易行,设备要求不高,可作为排除肺栓塞的首选试验,易在临床诊断中推广使用。

The Clinical Significance of Plasma D-dimer Detection in the Diagnosis of Excluding Pulmonary Embolism

Objective The aim of this study is to evaluate the value of the plasma D-dimer detection in the diagnosis of excluding pulmonary embolism.Methods D-dimer levels were determined by enzyme-linked immunoabsorbent assay (ELISA) in patient with suspicion of pulmonary embolism,and carries on for half year to those patients to make a follow-up visit to see whether they have the symptom of pulmonary embolism or deep phlebothrombosis.Results Of all the 102 patients included,were detected,D-dimer levels were below 500 μg/L in 42(41.1%)patients,D-dimer levels were above 500 μg/L in 60 patients,12 of them were proved were diagnosis of pulmonary embolis by pulmonary angiography V/Q.Lung scan Sensitivity and negative predictive values of D-dimer detection were 100%.Conclusion D-dimer detection is easy to work out and do not need complex equipment,it could be the first test of excluding pulmonary embolism,and is easyto spread in clinical diagnose.