老年下肢深静脉血栓患者D-二聚体的临界值研究  

Cut-off value of D-dimer in elderly patients with lower extremity deep venous thrombosis

作　　者：余美琴[1] 李俊来[1] 曹晓林[1] 白洁[2] 张舜欣[1] 刘欣[1] 林倩[1] 宋丹绯[1] 王节[1] 

机构地区：[1]解放军总医院南楼超声科,北京100853 [2]解放军总医院南楼检验科,北京100853

出　　处：《中华老年心脑血管病杂志》2013年第1期32-34,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：全军"十一五"计划保健专项课题(09BJZ02)

摘　　要：目的探讨老年患者血浆D-二聚体(DD)水平预测下肢深静脉血栓(DVT)的临界值。方法选择年龄≥60岁的住院患者394例,根据是否合并DVT,分为非DVT组235例和DVT组159例,DVT组60～79岁81例和≥80岁78例。住院期间,每隔1～2周进行血浆DD检查,对DD≥0.5mg/L的患者,即行下肢静脉血管超声检查,每隔3～5d进行超声复查,且DD检测时间缩短为每隔3～5d。结果与非DVT组比较,DVT组DD水平明显升高(P<0.01)。≥80岁患者DD水平较60～79岁患者明显升高(P<0.01);2个年龄段患者DD各临界值诊断下肢DVT的敏感性、特异性、阳性预测值及阴性预测值差异较大。结论将60～79岁患者预测下肢DVT的DD临界值定为0.5mg/L,≥80岁患者DD临界值定为2.0mg/L有临床指导意义。Objective To study the cut-off value of plasma D-dimer（DD） level in elderly patients with lower extremity deep vein thrombosis（DVT）. Methods Three hundred and ninety four hos pitalized patients with their age ≥60 years were divided into non-DVT group（n=235） and DVT group（n=159）. Patients in the DVT group were further divided into 60--79 years old group（n= 81）and ≥ 80 years old group（n=78）. Their DD level was measured every 1--2 weeks. Those with their DD level higher than 0.5 mg/L underwent ultrasonography of lower extremity DVT every 3--5 days. Results The DD level was significantly higher in DVT group than in non DVT group and in ≥ 80 years old group than in 60--79 years old group（P〈0.01）. The sensitivity, specificity,positive and negative predicting value of DD cut-off values were significantly different between the 60--79 years old group and ≥80 years old group. Conclusion The DD cut-off value is 0.5 mg/L and 2. 0 mg/L, respectively, for the diagnosis of lower extremity DVT in 60-- 79 years old patients and ≥ 80 year old patients.

关 键 词：静脉血栓形成 下肢 超声检查 多普勒 彩色 酶联免疫吸附测定 

分 类 号：R543.6[医药卫生—心血管疾病]