d -二聚体作为脑栓塞诊断生物标志物的价值：一项荟萃分析

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-08-05 DOI:10.1016/j.clineuro.2025.109089

Kai Yang, Aihua Huang, Xiaolin Wang, Yidan Zhou

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引用次数: 0

摘要

脑栓塞是急性缺血性卒中（AIS）的一种亚型。不同脑卒中亚型间d -二聚体水平差异有统计学意义。本荟萃分析评估了d -二聚体在脑栓塞诊断中的价值。方法检索PubMed、Cochrane Library、EMBASE、万方、中国知网数据库。采用QUADAS-2工具评价研究质量。通过SROC曲线、敏感性、特异性、PLR、NLR和DOR评估d -二聚体的诊断性能，其ci值为95% %。Cochran's Q检验和I²统计量测量了研究的异质性。本荟萃分析纳入了10项研究（652例脑栓塞患者和2683例其他AIS亚型患者）。d -二聚体在脑栓塞诊断中表现出良好的表现，其敏感性为0.77(95 % CI: 0.65-0.86)，特异性为0.79(95 % CI: 0.70-0.86)， AUC为0.85（95 % CI: 0.82-0.88）。其PLR为3.72（95 % CI: 2.62-5.29）和NLR为0.29（95 % CI: 0.19-0.44）进一步支持了其实用性，而DOR为12.92（95 % CI: 7.50-22.25）突出了其显著的诊断价值。病例类型被认为是异质性的主要来源（I2=76, P = 0.02）。结论d -二聚体对脑栓塞具有重要的诊断价值，在发病24 h内具有中等的敏感性和特异性。

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The value of D-dimer as a biomarker for the diagnosis of cerebral embolism: A meta-analysis

Background

Cerebral embolism is a subtype of acute ischemic stroke (AIS). D-dimer levels were significantly different among stroke subtypes. This meta-analysis evaluates the value of D-dimer for cerebral embolism diagnosis.

Methods

Literature was searched from PubMed, Cochrane Library, EMBASE, Wanfang, and China National Knowledge Infrastructure (CNKI) databases. The QUADAS-2 tool was used to evaluate study quality. D-dimer's diagnostic performance was assessed via SROC curves, pooled sensitivity, specificity, PLR, NLR, and DOR with their 95 % CIs. Cochran's Q test and I² statistic measured study heterogeneity.

Results

This meta-analysis enrolled ten studies (652 cerebral embolism patients and 2683 patients with other AIS subtypes). D-dimer showed promising diagnostic performance for cerebral embolism with a sensitivity of 0.77 (95 % CI: 0.65–0.86), specificity of 0.79 (95 % CI: 0.70–0.86), and an AUC of 0.85 (95 % CI: 0.82–0.88). Its PLR of 3.72 (95 % CI: 2.62–5.29) and NLR of 0.29 (95 % CI: 0.19–0.44) further supported its utility, while the DOR of 12.92 (95 % CI: 7.50–22.25) highlighted its significant diagnostic value. Case type was identified as the primary source of heterogeneity (I²=76, P = 0.02).

Conclusion

D-dimer has a significant diagnostic value for cerebral embolism, with moderate sensitivity and specificity within 24 h of onset.

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.