摘要
目的提高对D-二聚体正常的肺栓塞(PTE)的认识。方法回顾分析2004年1月至2009年12月入院、血浆D-二聚体正常并确诊PTE的9例患者的临床资料。结果 9例D-二聚体正常PTE患者中,仅1例W ells临床评分为3分,为临床PTE不可能组,肺动脉增强CT明确为段PTE。其他8例均为临床PTE可能患者,W ells临床评分为4.5～7.5分(中位数6.0分),病程1 h～2个月,D-二聚体为0.1～0.5 mg/L(中位数0.3 mg/L);肺动脉增强CT血栓位置:3例为亚段PTE,3例为段PTE,2例为主干PTE。结论 D-二聚体测试结果之后,至关重要的是先检查病人和进行临床可能性评估,在临床PTE可能患者中,一个正常的D-二聚体检测结果不能排除PTE,影像学检查仍然是必需的。
Objective To improve the knowledge of pulmonary embolism with normal D-dimer levels.Methods Nine consecutive patients of established pulmonary embolism with a normal D-dimer concentration admitted from January 2004 to December 2009 were analyzed retrospectively.Results Pulmonary embolism was confirmed in the 9 patients with a normal D-dimer concentration.Pulmonary embolism was confirmed in only one patient with an unlikely probability of pulmonary embolism.Wells score was 3 and the localization of the emboli was segmental emboli.In other 8 patients with a likely clinical probability of pulmonary embolism,the complaints of those patients existed between 1 hour and 2 months.Wells score was between 4.5 and 7.5,with a median of 6.0.D-dimer concentration was between 0.1 and 0.5 mg/L,with a median of 0.3 mg/L.The localization of the emboli was subsegmental emboli in 3 cases,segmental emboli in 4 cases,and central emboli in 2 cases.Conclusions Our findings indicate that it is essential to examine the patient and assess the clinical probability at the first,then the D-dimer concentration should be taken into account.In patients with a likely clinical probability,a normal D-dimer test result can not exclude pulmonary embolism,and additional imaging testing is necessary.
出处
《中国呼吸与危重监护杂志》
CAS
2011年第1期77-79,共3页
Chinese Journal of Respiratory and Critical Care Medicine
关键词
肺栓塞
深静脉血栓
D-二聚体
Pulmonary embolism
Deep venous thrombosis
D-dimer
