血清d -二聚体水平对排除急性主动脉夹层的回顾性分析。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2022-07-28 eCollection Date: 2022-01-01 DOI:10.2147/OAEM.S373335
Tony Zitek, Mani Hashemi, Sara Zagroba, Valori H Slane
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引用次数: 0

摘要

目的:急性主动脉夹层(AAD)是一种高度致命的疾病,如果不及时诊断。一些国际研究表明,血清d-二聚体水平可用于排除AAD,但数据有限。我们试图证实d-二聚体水平在美国AAD患者中升高。此外,我们试图估计d-二聚体对AAD的测试特征。患者和方法:我们对美国医院公司(Hospital Corporation of America)数据库中2015年至2019年间入院的患者进行了回顾性分析。我们查询了数据库,寻找诊断为AAD或(非特异性)胸痛的患者,并在到达医院24小时内进行了d-二聚体检查。将诊断为AAD和胸痛的患者的中位数d-二聚体进行比较。我们在标准临界值为500 ng/mL时估计了d-二聚体对AAD的检测特性。结果:共有48902例患者符合分析标准,其中AAD 572例,胸痛48330例。AAD组和胸痛组d-二聚体的中位数分别为2455 ng/mL和385 ng/mL (p < 0.0001)。以500 ng/mL为临界值,d-二聚体的敏感性为91.1%,特异性为71.4%。结论:AAD患者血清d-二聚体值高于非特异性胸痛患者。在标准临界值为500 ng/mL时,血清d-二聚体对AAD具有较高的敏感性,但不足以高到仅用d-二聚体水平就可用于分离排除AAD。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

A Retrospective Analysis of Serum D-Dimer Levels for the Exclusion of Acute Aortic Dissection.

A Retrospective Analysis of Serum D-Dimer Levels for the Exclusion of Acute Aortic Dissection.

Purpose: Acute aortic dissection (AAD) is a highly fatal disorder if not promptly diagnosed. Some international studies have suggested that serum d-dimer levels may be used to exclude AAD, but data are limited. We sought to confirm that d-dimer levels are elevated in American patients with AAD. Additionally, we sought to estimate the test characteristics of the d-dimer for AAD.

Patients and methods: We performed a retrospective analysis of patients in the Hospital Corporation of America database who arrived at the hospital between 2015 and 2019. We queried the database to find patients who had a diagnosis of AAD or (nonspecific) chest pain, and who also had a d-dimer performed within 24 hours of arrival at the hospital. The median d-dimer was compared in those diagnosed with AAD versus chest pain. We estimated the test characteristics of d-dimer for AAD at the standard cutoff value of 500 ng/mL.

Results: In total, 48,902 patients met the criteria for analysis, including 572 with AAD and 48,330 with chest pain. The median d-dimers were 2455 ng/mL and 385 ng/mL for the AAD and chest pain groups, respectively (p < 0.0001). Using a cutoff of 500 ng/mL, the sensitivity of the d-dimer was 91.1% and the specificity was 71.4%.

Conclusion: Serum d-dimer values are higher in patients with AAD than in those with nonspecific chest pain. At the standard cutoff of 500 ng/mL, the serum d-dimer has a high sensitivity for AAD, but not high enough that d-dimer levels alone can be used in isolation to exclude AAD.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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