| 引用本文： |
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杨勇,蔡明.高龄下肢骨折患者术后血栓预防中D-二聚体临界值的研究[J].同济大学学报（医学版）,2015,36(1):83-86. [点击复制]
- YANG Yong,CAI Ming.D-dimer plasma level for venous thromboembolism after operations among elderly patients with lower limb fractures[J].同济大学学报（医学版）,2015,36(1):83-86. [点击复制]
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| 摘要: |
| 目的 探讨更具临床价值的D-二聚体临界值及其在高龄下肢骨折患者术后血栓预防中的必要性。方法对112例年龄＞65岁的下肢骨折患者分别在术前第2天,术后第3、7、10天测定血浆D-二聚体水平。在术后第5天行双下肢血管多普勒超声检查。应用统计分析探讨更具临床价值的D-二聚体临界值。结果 术后D-二聚体水平较术前普遍升高。与深静脉血栓(deep vein thrombosis, DVT)阴性患者相比,DVT阳性患者D-二聚体水平显著升高。术后第3天,D-二聚体水平＞3mg/L诊断DVT的灵敏度和特异度分别为88.37%和86.96%。统计分析显示,以3mg/L作为D-二聚体临界值,受试者工作特征曲线下面积最大。结论 以3mg/L作为D-二聚体临界值,在高龄下肢骨折患者术后血栓预防中更具临床价值。 |
| 关键词: D-二聚体 深静脉血栓 高龄患者 下肢骨折 |
| DOI：10.16118/j.1008-0392.2015.01.018 |
| 投稿时间：2014-07-15 |
| 基金项目: |
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| D-dimer plasma level for venous thromboembolism after operations among elderly patients with lower limb fractures |
| YANG Yong,CAI Ming |
| (Dept. of Orthopedics, Tenth People's Hospital, Tongji University, Shanghai 200072, China) |
| Abstract: |
| ObjectiveTo evaluate the application of plasma D-dimer levels in prediction of venous thromboembolism(VTE) among elderly patients with lower limb fractures. MethodsPlasma D-dimer levels were assessed in 112 patients aged over 65 with lower limb fractures 2d before surgery and on d3, d7, d10 after surgery. Doppler ultrasonography of the lower extremity was performed to evaluate for VTE on d5 postoperatively. The cut-off level of plasma D-dimer for predicting VTE was analyzed. ResultsPlasma D-dimer levels were systematically raised postoperatively, and there was significant difference between patients with and without VTE. Taking D-dimer level>3mg/L at d3 after surgery as indicator for VTE, the sensitivity and specificity were 88.37% and 86.96%, respectively. ConclusionUsing a cut-off value of 3mg/L, plasma D-dimer levels can be used to indicate VTE with a high degree of sensitivity and specificity for elderly patients with lower limb fractures. |
| Key words: D-dimer venous thromboembolism elderly patients lower limb fractures |
