D-二聚体预测四肢骨折术后血栓性疾病的价值  

Value of D-dimer assay to predict thromboembolism after limb fracture surgery

作　　者：何伟民[1] 张晓龙 

机构地区：[1]上海市静安区中心医院骨科,200040

出　　处：《上海医学》2004年第8期575-577,共3页Shanghai Medical Journal

摘　　要：目的　探讨D 二聚体预测四肢骨折术后血栓性疾病的价值。方法　对我院 2 0 0 2年 12月 1日～2 0 0 3年 6月 30日住院的 85例四肢新鲜骨折患者进行术前血浆D 二聚体检测 ,术后随访 3个月 ,记录血栓性疾病的发生情况。结果　D 二聚体阳性和阴性患者的术后血栓性疾病发生率分别为 34.6 % (9/ 2 6例 )和 1.7% (1/5 9例 )。D 二聚体阳性预测血栓性疾病的特异性为 34.6 % ,敏感性为 90 .0 % ;D 二聚体阴性预测值为 98.3%(95 %可信区间为 95 .0 1～ 10 0 .0 0 % )。结论　四肢骨折患者D 二聚体阳性的特异性较差 ,预测血栓性疾病的意义不大 ;D 二聚体阴性预测值对排除四肢骨折术后并发血栓性疾病具有临床价值。术前检测D 二聚体是一种安全、价廉及非侵入性的方法。Objective To evaluate the value of D-dimer assay for predicting thromboembolism in limb fracture patients after operation. Methods From December 1, 2002 to June 30, 2003, 85 blood samples in preoperative limb fracture patients were obtained for testing D-dimer assay. After 3 mouths of followed-up, frequency of thromboembolism was recorded, and analyzed statistically. Results The frequencies of thromboembolism patients with D-dimer assay positive and negative after operation were 34.6%(9/26) and 1.7%(1/59) respectively. To predict the occurrence of thromboembolism with positive D-dimer assay showed a specificity of 34.6% and sensitivity of 90%; The negative predictive value (NPV) of the assay was 98.3%(95%Cls:95.01～100.00%). Conclusion The low specificity of positive D-dimer assay is of little value for predicting occurrence of thromboembolism in patients with limb fracture; therefor NPV of the D-dimer assay is very useful to exclude the possible occurrence of thromboembolism. D-dimer assay is also safe, inexpensive and noninvasive.

关 键 词：D-二聚体 预测 四肢骨折 术后 血栓性疾病 

分 类 号：R446.6[医药卫生—诊断学]