Plasma D-Dimer Changes and Clinical Value in Acute Lower Extremity Deep Venous Thrombosis Treated with Catheter-Directed Thrombolysis.

IF 2.8 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Jixu Wang, Yide Zheng, Yongzhong Yu, Xiaowen Fan, Shaofei Xu
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Abstract

Objective: This study sought to investigate the changes in plasma D-dimer levels during catheter-directed thrombolysis (CDT) in patients with acute lower extremity deep venous thrombosis (DVT), analyze imaging results, and assess their clinical implications.

Methods: We retrospectively analyzed 62 patients diagnosed with acute lower extremity DVT who underwent CDT between March 2019 and December 2022. Plasma D-dimer levels were measured before CDT, at regular intervals after CDT, and at the end of CDT. Lower limb venography was performed every two days during CDT to assess the thrombus clearance rate and level of thrombus dissolution. Statistical analysis was conducted to observe the D-dimer concentration changes and analyze the correlation between D-dimer concentration and thrombus clearance rate. Additionally, a receiver operating characteristic (ROC) curve was constructed to determine the diagnostic performance of D-dimer in assessing the efficacy of thrombolysis, including the calculation of the area under the curve (AUC), sensitivity, specificity, and optimal cut-off value.

Results: During CDT for acute lower extremity DVT, plasma D-dimer levels rapidly increased, peaking on CDT day 1, and then gradually decreased, followed by a rapid decline but remained slightly elevated compared to normal levels. There was a positive correlation between D-dimer levels and thrombolysis efficacy (r = 0.809, P = 0.00). The linear regression equation for this correlation was Y = 0.161 + 0.028X. The AUC of D-dimer was 0.95, with a cut-off value of 9.935 mg/L (sensitivity 93.2% and specificity 95.4%).

Conclusion: Plasma D-dimer concentration can serve as an indicator for evaluating the efficacy of thrombolysis during CDT in acute lower extremity DVT.

经导管溶栓治疗急性下肢深静脉血栓患者血浆d -二聚体的变化及其临床价值。
目的:本研究旨在探讨急性下肢深静脉血栓形成(DVT)患者导管溶栓(CDT)期间血浆d -二聚体水平的变化,分析影像学结果,并评估其临床意义。方法:回顾性分析了2019年3月至2022年12月期间接受CDT治疗的62例急性下肢DVT患者。在CDT前、CDT后和CDT结束时定期测量血浆d -二聚体水平。CDT期间每两天进行一次下肢静脉造影,评估血栓清除率和血栓溶解水平。通过统计分析观察d -二聚体浓度变化,分析d -二聚体浓度与血栓清除率的相关性。此外,构建受试者工作特征(ROC)曲线,确定d -二聚体在评估溶栓疗效方面的诊断性能,包括计算曲线下面积(AUC)、敏感性、特异性和最佳截止值。结果:急性下肢DVT CDT期间,血浆d -二聚体水平迅速升高,在CDT第1天达到峰值,随后逐渐下降,随后迅速下降,但与正常水平相比仍略有升高。d -二聚体水平与溶栓疗效呈正相关(r = 0.809, P = 0.00)。线性回归方程为Y = 0.161 + 0.028X。d -二聚体的AUC为0.95,临界值为9.935 mg/L(敏感性93.2%,特异性95.4%)。结论:血浆d -二聚体浓度可作为评价急性下肢DVT CDT溶栓效果的指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of vascular surgery. Venous and lymphatic disorders
Journal of vascular surgery. Venous and lymphatic disorders SURGERYPERIPHERAL VASCULAR DISEASE&n-PERIPHERAL VASCULAR DISEASE
CiteScore
6.30
自引率
18.80%
发文量
328
审稿时长
71 days
期刊介绍: Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.
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