血浆D-二聚体检测对缺血性结肠炎的诊断价值分析  

Diagnosis Value of Plasma D-Dimer Test for Ischemic Colitis

作　　者：文毅[1] 

机构地区：[1]广东省惠州市第三人民医院,516001

出　　处：《中国全科医学》2012年第27期3183-3184,共2页Chinese General Practice

摘　　要：目的缺血性结肠炎早期临床症状不明显,易于漏诊,肠系膜下选择性动脉造影为诊断该病的"金标准",但价格昂贵。本研究旨在探讨血浆D-二聚体检测对缺血性结肠炎的诊断价值,以寻找简便、经济、敏感的诊断方法。方法对我院2009年6月—2011年6月收治的39例疑似缺血性结肠炎患者腹痛发作24 h内抽血检测血浆D-二聚体水平,再行肠系膜下选择性动脉造影明确诊断。应用Prism 3.0统计软件分析血浆D-二聚体检测对缺血性结肠炎的诊断价值。结果根据血浆D-二聚体检测结果,诊断为缺血性结肠炎患者28例,血浆D-二聚体水平平均为(1.70±0.10)mg/L;非缺血性结肠炎患者11例,血浆D-二聚体水平平均为(0.18±0.02)mg/L。二者血浆D-二聚体水平比较,差异有统计学意义(t=49.6378,P<0.05)。根据肠系膜下选择性动脉造影结果,确诊为缺血性结肠炎患者30例,非缺血性结肠炎患者9例。血浆D-二聚体检测诊断缺血性结肠炎的灵敏度为86.67%,特异度为77.78%,阳性似然比为3.90。结论 D-二聚体检测诊断缺血性结肠炎的灵敏度和特异度较高,有较好的诊断价值,且简便、经济,值得临床推广应用。临床诊断本病时应详细询问患者病史,全面分析病情,结合辅助检查,对可疑患者及时行肠系膜下选择性动脉造影或结肠镜检查以明确诊断。Objective Ischemic colitis is easy to be misdiagnosed due to its unobvious early clinical symptoms. Selective arteriography of inferior mesenteric artery is the gold standard for ischemic colitis hut is very expensive. This study aims to investigate the diagnostic value of plasma D - dimer test for ischemic colitis in order to find a simple, economical and sensitive diagnosis method. Methods 39 suspected cases of ischemic colitis admitted to our hospital from June 2009 to June 2011 were drew blood 24 h within the attack of abdominal pain to test D - dimer, and then were confirmed by selective arteriography of inferior mesenteric artery. Statistical software of Prism 3.0 was used to analyze the diagnostic value of D - dimer test for ischemic colitis. Results According to the results of D - dimer, 28 cases were diagnosed as ischemic colitis and their average D - dimer level was （ 1.70 ± 0. 10） mg/L. 11 cases were diagnosed as non - ischemic colitis and their average D - dimer level was （0. 18 ±0. 02） mg/L. The difference of the D - dimer level between the two groups was statistically significant （ t = 49.6378, P 〈 0. 05 ） . According to the results of selective arteriography of inferior mesenteric artery, 30 cases were confirmed as ischemic colitis and 9 cases were confirmed as non - ischemic colitis. The sensitivity, specificity and positive likelihood ratio of D - dimer test for the diagnosis of ischemic cohtis were 86.67%, 77.78% and 3.90 respectively. Conclusion D - dimer test, with high sensitivity and specificity, has good diagnostic value in the diagnosis of ischemic colitis, and it is also simple and economical, deserving to be promoted in clinic. During diagnosis, the disease history of the patients should be inquired in detail to comprehensively analyze the disease assisted by auxiliary examination. Suspected cases should be given selective arteriography of inferior mesenteric artery or colonoscopy timely to confirm diagnosis.

关 键 词：结肠炎 缺血性 D-二聚体 诊断 

分 类 号：R574[医药卫生—消化系统]