The value of D-dimer in the detection of early deep-vein thrombosis after total knee arthroplasty in Asian patients: a cohort study.
The value of D-dimer in the detection of early deep-vein thrombosis after total knee arthroplasty in Asian patients: a cohort study.
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DOI：
10.1186/1477-9560-6-5
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发表时间：
2008-05-28
影响因子：
3.1
通讯作者：
Huang CC
中科院分区：
文献类型：
--
作者：
Chen CJ;Wang CJ;Huang CC
D-二聚体与全膝关节置换术后深静脉血栓形成的关系仍存在争议。本研究的目的是评估D-二聚体在TKA术后早期DVT检测中的价值。对78例接受TKA的患者在术前和术后第7天测定血浆D-二聚体水平。术后7 ~ 10天行静脉造影。血浆D-二聚体水平与下肢深静脉血栓形成有显著相关性。在40%的患者中确定了静脉造影DVT。DVT患者血浆D-二聚体水平>2.0 μg/ml者占68%，无DVT者占45%（P < 0.05）。因此，D-二聚体水平高于2.0 μg/ml时，检测TKA术后早期DVT的敏感性为68%，特异性为55%，准确性为60%，阳性预测率为50%，阴性预测率为72%。高血浆D-二聚体水平是检测TKA术后早期DVT的一个中等敏感性但特异性较差的指标。单独测量血清D-二聚体不足以准确检测TKA后的DVT。对于D-二聚体升高和临床疑似但无症状的TKA后DVT患者，建议进行静脉造影。
The relationship of D-dimer and deep-vein thrombosis (DVT) after total knee arthroplasty (TKA) remains controversial. The purpose of this study was to assess the value of D-dimer in the detection of early DVT after TKA. The measurements of plasma D-dimer level were obtained preoperatively and at day 7 postoperatively in 78 patients undergoing TKA. Ascending venography was performed in 7 to 10 days after surgery. The plasma D-dimer levels were correlated statistically with the venographic DVT. Venographic DVT was identified in 40% of patients. High plasma D-dimer level >2.0 μg/ml was found in 68% of patients with DVT and 45% without DVT (P < 0.05). Therefore, high D-dimer level greater than 2.0 μg/ml showed 68% sensitivity, 55% specificity, 60% accuracy, 50% positive predictive rate and 72% negative predictive rate in the detection of early DVT after TKA. High plasma D-dimer level is a moderately sensitive, but less specific marker in the detection of early of DVT after TKA. Measurement of serum D-dimer alone is not accurate enough to detect DVT after TKA. Venography is recommended in patients with elevated D-dimer and clinically suspected but asymptomatic DVT after TKA.