摘要
目的探讨联合检测D-二聚体(D-dimer,DD)和纤维蛋白原(fibrinogen,FIB)在下肢深静脉血栓形成(deep venous thrombosis,DVT)诊断中的应用价值。方法选取2013年1月至2014年9月承德医学院附属医院血管外科收治的DVT患者50例为DVT组,其中男性28例,女性22例,年龄(45.6±5.2)岁。选取我科同期收治的非血栓性疾病患者50例为非血栓性疾病对照组,其中男性25例,女性25例,年龄(47.5±2.3)岁,包括下肢大隐静脉曲张18例、下肢动脉硬化闭塞症22例、颈动脉狭窄5例、腹主动脉瘤2例、主动脉夹层3例。选取我院体检中心健康体检者40例为正常对照组,其中男性19例,女性21例,年龄(46.7±3.9)岁。检测3组DD及FIB的血清浓度。结果 3组DD和FIB的血清浓度分别为DVT组(0.91±0.26)mg/L和(5.18±0.09)g/L,非血栓性疾病对照组(0.54±0.06)mg/L和(4.57±0.69)g/L,正常对照组(0.29±0.09)mg/L和(2.71±0.29)g/L。DVT组DD和FIB的血清浓度均显著高于非血栓性疾病对照组和正常对照组(P<0.05)。DD诊断DVT的敏感性与特异性分别为90.00%和74.44%,阳性预测值与阴性预测值分别为65.67%和91.78%;FIB诊断DVT的敏感性与特异性分别为74.00%和76.67%,阳性预测值与阴性预测值分别为63.79%和84.15%;DD和FIB联合检测诊断DVT的敏感性与特异性分别为92.00%和73.33%,阳性预测值与阴性预测值分别为65.71%和94.29%。结论联合检测血清DD和FIB的水平能够提高DVT早期诊断的阳性检出率并且降低其漏诊率,具有重要的临床价值。
Objective To explore the application value of combined detection of D-dimer（ DD） and fibrinogen（ FIB） in the diagnosis of deep venous thrombosis（ DVT）. Methods The study included 3groups： a DVT group,a non-thrombotic disease control group and a normal control group. The DVT group consisted of 50 patients with the mean age of 45. 6 ± 5. 2 years,who were diagnosed with DVT（ 28 males and22 females） and admitted to the vascular surgery department of affiliated hospital of Chengde medical college from January 2013 to September 2014. The non-thrombotic disease control group consisted of 50 patients with the mean age of 47. 5 ± 2. 3 years,who were documented with non-thrombotic disease（ 25 males and 25females） and admitted to the department during the same period,and there were 18 cases of great saphenous varicose veins of lower limb,22 cases of lower extremity atherosclerotic occlusive disease,5 cases of carotid artery stenosis,2 cases of abdominal aortic aneurysm and 3 cases of aortic dissection. The normal control group consisted of 40 healthy people with the mean age of（ 46. 7 ± 3. 9） years old,who were checked-up in our hospital（ 19 males and 21 females）. The serum concentrations of DD and FIB were tested. Results The serum concentrations of DD and FIB were 0. 91 ± 0. 26 and 5. 18 ± 0. 09 g / L in the DVT group,0. 54 ± 0. 06 and 4. 57 ± 0. 69 g / L in the non-thrombotic disease control group,and 0. 29 ± 0. 09 and 2. 71 ± 0. 29 g / L in the normal control group,respectively. The levels of DD and FIB in the DVT group were significantly higher than those of the other groups（ P 0. 05）. The diagnostic sensitivity,specificity,positive predictive value and negative predictive value of DD for DVT were 90. 00%,74. 44%,65. 67% and 91. 78%,respectively.The corresponding values of FIB for DVT were 74. 00%,76. 67%,63. 79% and 84. 15%,respectively.Furthermore,the corresponding values of combined detection of DD and FIB for DVT were 92. 00%,73. 33%,65. 71% and 94. 29%,respectively. Conclusion Combined detection of serum DD and FIB levels has an important clinical value. It can improve the positive detection rate and decrease the missed diagnosis in the early diagnosis of DVT.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第16期1885-1888,共4页
Journal of Third Military Medical University
