D-二聚体在深静脉血栓形成诊断中临界值的确定  

Clinical signification of D-dimer and the determination ofits cut-off value for patients with deep venous thrombosis

作　　者：汪波[1] 徐向东[2] 刘敏[1] 姜傥[1] 张式鸿[1] 欧阳涓[1] 蔡丹[1] 

机构地区：[1]中山大学附属第一医院检验科,广州510080 [2]中山大学附属第一医院血管外科,广州510080

出　　处：《中华普通外科学文献（电子版）》2012年第2期21-23,54,共4页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的评估D-二聚体的临床应用价值并建立D-二聚体在深静脉血栓形成(DVT)诊断中的临界值。方法应用免疫比浊法分别检测DVT患者108例,非DVT可疑患者94例及健康对照96例的血浆D-二聚体含量,通过绘制接受者工作特征曲线(ROC)确立本实验室D-二聚体在DVT诊断中的临界值。结果与非DVT可疑患者相比较,DVT患者D-二聚体水平显著增加(P<0.01);与健康对照组比较,非DVT可疑患者D-二聚体水平显著增加(P<0.01),DVT患者中D-二聚体的ROC曲线下面积为0.914(SD:0.030;95%CI:0.86～0.97),临界值为250μg/L(敏感度0.85,特异性0.89,Youden指数0.74,阴性似然比0.17)。结论 D-二聚体有较高的临床应用价值。建立本实验室的D-二聚体临界值有助于临床对DVT的安全排除。Objective To evaluate the clinical signification of D-dimer and determine it＇s cut-off value for patients with deep venous thrombosis （DVT） in the local laboratory. Methods Plasma D-dimer levels were measured by immunoturbidimetric method in 108 cases with DVT, 94 suspected patients without DVT and 96 healthy subjects. The results were compared and the cut-off value was determined by the receiver operating characteristic curve analysis. Results The plasma levels of D-dimer were significantly higher in patients with DVT than in patients without DVT （P 〈 0.01 ） and those were significantly higher in patients without DVT than in healthy subjects （P 〈 0.01 ）. The area under the curve was 0.914 for DVT （SD：0.030; 95% CI：0.86-0.97）. The appropriate cut-off value of D-dimer for the patients with DVT was 250 p,g/L（sensitivity 0.85, specificity 0.89, Youden＇s index 0.74, negative likelihood Ratio 0.17）. Conclusions The D-dimer level is a valuable indicator in the clinical medicine. The appropriate cut-off value of D-dimer in the local laboratory will rule out DVT more safely.

关 键 词：接受者工作特征曲线 深静脉血栓形成 D-二聚体 临界值 

分 类 号：R445.1[医药卫生—影像医学与核医学]