d -二聚体和d -二聚体/纤维蛋白原比值预测医院急诊科评估患者肺栓塞

IF 1.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
H Kara, A Bayir, S Degirmenci, S A Kayis, M Akinci, A Ak, B Celik, A Dogru, B Ozturk
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引用次数: 19

摘要

目的:d -二聚体水平、纤维蛋白原水平和d -二聚体/纤维蛋白原比值用于肺栓塞的诊断,但结果不同。我们评估了这些参数在急诊临床患者肺栓塞诊断中的价值。方法:在本前瞻性研究中,200例患者(肺栓塞,100例;无肺栓塞(100例),干预前检测d -二聚体和纤维蛋白原水平。肺栓塞诊断为计算机断层血管造影或通气灌注显像。结果:与未发生肺栓塞的患者相比,肺栓塞患者的平均d -二聚体水平显著升高(肺栓塞,6±7 μg/ml;无肺栓塞,1±1 μg/ml;P < 0·001)和d -二聚体/纤维蛋白原比值(肺栓塞,3±3;无肺栓塞,0·4±0·4;P≤0.001),但平均纤维蛋白原水平相似(肺栓塞,337±184 mg/dl;无肺栓塞,384±200 mg/dl;不显著)。在肺栓塞患者中,高危患者的平均d -二聚体水平和d -二聚体/纤维蛋白原比值高于非高危患者。d -二聚体截止值为0.35 μg/ml时,对肺栓塞的敏感性高(100%),特异性低(27%)。d -二聚体/纤维蛋白原比值为0.13时,对肺栓塞的敏感性高(100%),特异性低(37%)。结论:d -二聚体水平
本文章由计算机程序翻译,如有差异,请以英文原文为准。
D-dimer and D-dimer/fibrinogen ratio in predicting pulmonary embolism in patients evaluated in a hospital emergency department.

Objectives: The D-dimer level, fibrinogen level, and D-dimer/fibrinogen ratio are used in the diagnosis of pulmonary embolism, but results vary. We evaluated these parameters in the diagnosis of pulmonary embolism in emergency clinic patients.

Methods: In this prospective study, 200 patients (pulmonary embolism, 100 patients; no pulmonary embolism, 100 patients) had D-dimer and fibrinogen levels measured before intervention. Pulmonary embolism was diagnosed with computed tomography angiography or ventilation-perfusion scintigraphy.

Results: Compared with patients who did not have pulmonary embolism, patients who had pulmonary embolism had significantly greater mean D-dimer level (pulmonary embolism, 6±7 μg/ml; no pulmonary embolism, 1±1 μg/ml; P⩽0·001) and D-dimer/fibrinogen ratio (pulmonary embolism, 3±3; no pulmonary embolism, 0·4±0·4; P⩽0·001), but similar mean fibrinogen levels (pulmonary embolism, 337±184 mg/dl; no pulmonary embolism, 384±200 mg/dl; not significant). In patients who had pulmonary embolism, mean D-dimer level and D-dimer/fibrinogen ratio were greater in high-risk than non-high-risk patients. With D-dimer cutoff 0·35 μg/ml, sensitivity was high (100%) and specificity was low (27%) for pulmonary embolism. With D-dimer/fibrinogen ratio cutoff 0·13, sensitivity was high (100%) and specificity was low (37%) for pulmonary embolism.

Conclusion: A D-dimer level <0·35 μg/ml may exclude the diagnosis of pulmonary embolism. At a D-dimer cutoff 0·5 μg/ml and D-dimer/fibrinogen ratio cutoff 1·0, the D-dimer/fibrinogen ratio may have better specificity than D-dimer level in the diagnosis of pulmonary embolism, but the D-dimer/fibrinogen ratio may lack sufficient specificity in screening.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica MEDICINE, GENERAL & INTERNAL-
CiteScore
3.50
自引率
0.00%
发文量
44
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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