D-二聚体在老年髋骨骨折患者术后血栓形成的诊断价值  

Diagnosis Performance of D-dimmer Levels for Thrombosis in Old Postoperative Patients with Hip Fracture

作　　者：曾文[1] 陈红玲[2] 罗福东[3] 吴新忠[3] 

机构地区：[1]广东省妇幼保健院检验科,广州510010 [2]茂名市人民医院检验科,广东茂名525200 [3]广东省中医院检验科,广州510120

出　　处：《现代检验医学杂志》2013年第2期139-140,144,共3页Journal of Modern Laboratory Medicine

摘　　要：目的评价血浆D二聚体（DD）水平在老年髋骨骨折患者术后血栓形成的诊断价值。方法选择46例健康老年人作为对照组，检测血浆D-二聚体含量，建立Liatest STAGO DD方法检测D-二聚体的参考区间。选择70例老年髋骨骨折患者设为实验组，检测术后第七天血浆D-二聚体结果，与“金标准”彩色多普勒超声检查进行比较，评价D-二聚体在术后血栓形成中的诊断价值。结果健康老年人群胁二聚体的参考区间为220～640μg／L，髋骨骨折患者术后第七天D-二聚体水平为5397±7008μg／L，两者差异有统计学意义（Z=9．13，P〈0．05）。根据ROC曲线分析，血浆D-二聚体诊断临界值为4545μg／L时，对老年髋关节骨折患者血栓形成诊断的敏感度、特异度和Youden指数分别为75％，60％和35％，ROC曲线下面积为0．675。当诊断临界值为640μg／L时，敏感度为100％，阴性预测值（NPV）为100％。结论Liatest STAGO DD方法测定D-二聚体对老年髋骨骨折患者术后血栓形成的诊断有一定诊断价值，但更大的是排除诊断价值。Objective To evaluate the diagnosis preformance of D-dimer levels （DD） for thrombosis in old postoperative patients with hip fracture. Methods The plasma D-dimer levels of 46 old health people were measured with Liatest STAGO DD assay,and used to build the reference range. Compared with the golden standard test of Color Doppler Ultrasonography examination, D-dimer levels of 70 hip fractured patients in 7 days after operation were assessed the diagnosis preformance for thrombosis. Results The reference range of Liatest STAGO DD assay for old health people was 220 to 640 μg/L and D-dimet levels of 70 hip fractured patients in 7 days after operation were 5 397 ± 7 008μg/L. There was significant difference between the two （Z= 9.13, P〈0.05）. When the cut-off value was 4 545 μg/L, the diagnosis preformanee of D-dimmer for thrombosis were 0. 675 of the area under the curve （AUC）, 75 %0 of sensitivity, 60% of specificity. When the cut-off value was 640 μg/L,there were 100% of sensitivity and 100% of negative predictive value （NPV）. Conclusion The plasma levels of D-dimmer had better exclusion than diagnosis performance for thrombosis in old postoperative patients with hip fracture.

关 键 词：D-二聚体 血栓 诊断价值 

分 类 号：R683[医药卫生—骨科学] R446.112[医药卫生—外科学]