血浆D-二聚体水平对不同年龄段患者静脉血栓诊断界值的研究  

D-dimer levels of venous thrombosis in patients with the diagnosis of critical value of different ages

作　　者：赵天丽[1] 

机构地区：[1]浙江省杭州市余杭区第五人民医院检验科,杭州311100

出　　处：《中国医师杂志》2015年第5期675-677,共3页Journal of Chinese Physician

基　　金：国家自然科学基金资助项目（30900641）

摘　　要：目的 比较住院患者与健康对照者间血浆D-二聚体（D-D）水平,并探讨不同年龄段两组D-D水平的变化特点,采用ROC曲线分析不同年龄段血浆D-D诊断静脉血栓栓塞（VTE）的临床价值.方法 选择健康体检者5 798例（对照组）和住院患者3 756例（观察组）为研究对象,采集血样并测定、分析血浆D-D水平.结果 ≤50岁健康对照和住院患者间D-D水平差异无统计学意义（P＞0.05）,＞50岁两组研究对象的D-D水平随年龄增长显著增高;D-D水平与VTE的发生率均呈正相关关系（r =0.9189,P＜0.05）;≤50岁组的住院患者依据D-D诊断VTE的灵敏度和特异度均最高,随年龄增长,D-D诊断VTE的灵敏度和特异度均下降.结论 血浆D-D水平随年龄的增长而升高,D-D诊断老年人VTE的敏感度显著下降,对于老年人应结合多种指标综合诊断VTE.Objective To compare plasma D-dimmer （D-D） levels of hospitalized patients and healthy controls,and to investigate D-D level changes in different age groups and receiver operating characteristic （ROC） curve analysis were used to analyze the clinical value of diagnosis of venous thromboembolism （VTE） by plasma D-dimer in different ages.Methods Totally 5798 healthy cases and 3756 cases of hospitalized patients were used for this study.Blood samples were collected and plasma D-dimer levels were analyzed.Results No significant difference was found in D-D level between the 50-year old hospitalized patients and healthy controls.D-D level of more than 50-year-old patient groups studied were significantly higher.D-D level was positively related to occurrence of VTE rate （r =0.9189,P 〈0.05）.The sensitivity and specificity of D-D diagnosis of VTE in 50-year-old hospitalized patients were the highest,with the increase of age,the sensitivity and specificity of D-D diagnosis of VTE were decreased.Conclusions Plasma D-dimer levels were increased with age,The sensitivity of D-dimer was significantly decreased in the diagnosis of VTE of the elderly.The comprehensive indices should be used in the diagnosis of VTE.

关 键 词：纤维蛋白纤维蛋白原降解物/代谢 静脉血栓栓塞/代谢/诊断 年龄因素 

分 类 号：R543.6[医药卫生—心血管疾病]