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不同年龄患者D-二聚体排除诊断静脉血栓临界值的研究

任静   

  1. 天津医科大学总医院
  • 收稿日期:2013-07-02 修回日期:2013-09-13 出版日期:2014-01-15 发布日期:2014-01-15
  • 通讯作者: 任静

Study on cut-off value with D-dimer for diagnosis by exclusion with venous thromboembolism in various age patients

ren jing   

  • Received:2013-07-02 Revised:2013-09-13 Published:2014-01-15 Online:2014-01-15
  • Contact: ren jing

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摘要： 目的 分析健康人群和住院患者血浆D-二聚体水平随年龄增长的变化特征， 探讨不同年龄段血浆D-二聚体排除诊断老年人静脉血栓栓塞 （VTE） 的临界值。方法 选择健康体检者6 717例和住院患者2 976例。采用法国生物梅里埃VIDAS荧光免疫分析仪测定血浆D-二聚体水平。结果 40岁以上健康人群随年龄增长， 血浆D-二聚体水平显著增高 （P < 0.01）， 住院患者各年龄组血浆D-二聚体水平存在同样变化趋势， VTE发生率也随年龄增加而增加。D-二聚体诊断≤40岁组患者VTE的临界值为504 μg/L， 敏感度为100.0%； 41~60岁组的临界值为565 μg/L，敏感度为96.2%； 61~74岁组的临界值为817 μg/L， 敏感度为80.8%； ≥75岁组的临界值为1 024 μg/L， 敏感度为73.1%。结论 血浆D-二聚体水平随年龄的增长而增高， 老年患者D-二聚体排除诊断VTE的临界值高于其他年龄组， 但诊断敏感度显著下降。

关键词: 年龄, D-二聚体, 静脉血栓栓塞, 排除, 临界值

Abstract: Objective To investigate the plasma level of D-dimer in various age healthy groups, to analyze the variation characteristics of D-dimer levels with age in healthy groups, and examine the cut-off value with D-dimer of rule out venous thromboembolism in the older patients. Methods 6717 healthy individuals and 2976 hospitalized patients were selected from the Tianjin medical university general hospital from the 2011 to 2013. Using the Biomerieux VIDAS fluor-euzymelinked immunoassay analyzer assay the level of D-dimer. Results Rising levels of plasma D-dimer with age in healthy group (P<0.01), and the random patients groups of various age had the same tendency. The diagnosis cut-off value with venous thromboembolism of D-dimer was 504 ng/ml in patients group aged ≤40 years, 565 ng/ml in 41~60 years group, 817 ng/ml in 61~74 years group and 1024 ng/ml in ≥75 years group. Conclusion Plasma D-dimer level increased with age, the older patients had D-dimer cur-off value higher than other age groups, but the diagnosis sensitivity was decreased obiously.

Key words: age, D-dimer, venous thromboembolism, rule out, cut-off value