血浆D-二聚体检测与彩色多普勒超声在下肢深静脉血栓诊断中的临床意义(PDF)
《中国普外基础与临床杂志》[ISSN:1007-9424/CN:51-1505/R]
- 期数:
- 2010年07期
- 页码:
- 668-671
- 栏目:
- 专题
- 出版日期:
- 2010-07-22
文章信息/Info
- Title:
- Value of Color Doppler Ultrasonography and Plasma D-imer in Diagnosis of Lower Limb Venous Thrombosis
- 稿件编号:
- 201007008
- Author(s):
- ZHU Bing; TIAN Guang-ei; GE Xiao-u .
- Department of Vascular Surgery, The People’s Hospital of Xinjiang Urgur Autonomous Region, Urumchi 830001, China
- Keywords:
- ; Deep venous thrombosis; D-imer; Color Doppler ultrasonography; Phlebography
- 分类号:
- R654.4
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨D-二聚体和彩色多普勒超声在下肢深静脉血栓形成（DVT）中的诊断价值。
方法 回顾性分析我科2008年1月至2010年4月期间收治的70例临床诊断为下肢DVT患者的临床资料，记录血浆D-二聚体检测和彩色多普勒超声检查结果，同时比较深静脉血栓形成不同时期和不同分型中D-二聚体水平变化。
结果 D-二聚体检测和彩色多普勒超声检查诊断下肢静脉血栓的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为100%、66.7%、97.0%、100%、97.1%和98.4%、83.3%、98.4%、83.3%、97.1%。血浆D-二聚体水平在深静脉血栓形成的急性期〔(6 451±4 012.22) μg/L〕和亚急性期〔(2 063±1 831.35) μg/L〕明显高于正常对照组水平〔(310±66.70) μg/L〕，P<0.01和P<0.05，而慢性期患者的D-二聚体水平〔(466±350.52) μg/L〕与正常对照组相比差异无统计学意义（P>0.05）。中央型〔(2 149±1 911.53) μg/L〕和混合型〔(4 464±3 753.16) μg/L〕患者血浆D-二聚体水平明显高于正常对照组（P<0.05和P<0.01），周围型患者血浆D-二聚体水平〔(560±315.62) μg/L〕接近正常对照组水平（P>0.05）。
结论 彩色多普勒超声检查的敏感性及特异性较高，可作为下肢DVT患者的首选检查； D-二聚体在急性DVT患者中敏感性较高，可作为DVT的预测指标。
- Abstract:
- Objective To explore the value of color Doppler ultrasonography and plasma D-dimer in diagnosis of lower limb deep venous thrombosis (DVT).
Methods The clinical data of 70 cases of patients with lower limb DVT diagnosed clinically were retrospectively studied. The lower limb venous of each patient was examined by color Doppler ultrasonography and the plasma level of D-dimer were measured, furthermore the plasma levels of D-dimer in different phase and different type of thrombosis were compared.
Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of plasma D-dimer and ultrasonography examination in lower limb DVT were 100%, 66.7%, 97.0%, 100%, and 97.1%, and 98.4%, 83.3%, 98.4%, 83.3%, and 97.1%, respectively. The plasma D-dimer in acute phase 〔(6 451±4 012.22) μg/L〕 and subacute phase 〔(2 063±1831.35) μg/L〕 of lower limb venous thrombosis were significantly higher than that in normal control group 〔(310±66.70) μg/L〕, P<0.01 and P<0.05, which was not different from that in chronic phase 〔(466±350.52) μg/L〕. Meanwhile, the plasma D-dimer in mixed limb venous thrombosis group 〔(4 464±3 753.16) μg/L〕 and central limb venous thrombosis group 〔(2 149±1 911.53) μg/L〕 were significantly higher than that in control group (P<0.05 and P<0.01), which was not different from that in peripheral limb venous thrombosis group 〔(560±315.62) μg/L〕.
Conclusion Color Doppler ultrasonography is an optimal method and the plasma D-dimer is a predictive index in diagnosis of lower limb DVT.
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备注/Memo
- 备注/Memo:
- 【通讯作者】戈小虎，E-mail: gexiaohu-xj@sohu.com
【作者简介】朱兵(1965年-)，男，河南省沁阳市人，大学，副主任技师，主要从事肝胆血管外科疾病基础研究，Email: zhubing65@sohu.com。
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