Evaluation of soluble P-selectin as a marker for the diagnosis of deep venous thrombosis.
Evaluation of soluble P-selectin as a marker for the diagnosis of deep venous thrombosis.
复制标题
DOI：
10.1177/1076029611405032
复制
发表时间：
2011-08
期刊：
影响因子：
--
通讯作者：
Wakefield TW
中科院分区：
文献类型：
--
作者：
Ramacciotti E;Blackburn S;Hawley AE;Vandy F;Ballard-Lipka N;Stabler C;Baker N;Guire KE;Rectenwald JE;Henke PK;Myers DD Jr;Wakefield TW
D-二聚体和威尔斯评分联合检测可排除但不能确诊深静脉血栓形成（DVT）。由于血栓形成和炎症是相互关联的，我们评估了可溶性P-选择素（sPsel）与其他炎症生物标志物的组合用于诊断DVT。通过双功扫描，对62例阳性和116例阴性DVT患者的sPsel、D-二聚体、C-反应蛋白（CRP）、微粒（总微粒、白细胞和血小板衍生微粒以及组织因子阳性微粒- MP）和临床威尔斯评分进行前瞻性评价。区分DVT阳性与阴性的生物标志物和临床评分为sPsel（87.3与53.4 ng/ml，p<0.0001）、D-二聚体（5.8与2.1 mg/L，p<0.0001）、CRP（2.1与0.8 μg/ml，p<0.0005）和威尔斯评分（3.2与2.0，p<0.0001）。对于MP分析，发现血小板衍生的MP可区分DVT和阴性。多因素Logistic回归分析显示，sPsel评分和威尔斯评分的联合应用可诊断DVT（cut-point ≥90 ng/ml +威尔斯≥2），特异性为96%，阳性预测值（PPV）为100%，可排除DVT诊断（cut-point ≤60 ng/ml，威尔斯<2）敏感性为99%，特异性为33%，阴性预测值（NPV）为96%。这项研究建立了一个生物标志物和临床特征的组合，可以确认和排除DVT的诊断。
The combination of D-dimer and Wells score can exclude, but not confirm, the diagnosis of deep venous thrombosis (DVT). Since thrombosis and inflammation are interrelated, we evaluated the combination of soluble P-selectin (sPsel) with other inflammatory biomarkers for the diagnosis of DVT. Sixty-two positive and 116 negative DVT patients, by duplex scan, were prospectively evaluated for sPsel, D-dimer, C-reactive protein (CRP), microparticles (total, leukocyte and platelet-derived and tissue factor positive microparticles - MP) and clinical Wells score. Biomarkers and clinical scores that differentiated DVT positives from negatives were sPsel (87.3 versus 53.4 ng/ml, p<0.0001), D-dimer (5.8 versus 2.1 mg/L, p<0.0001), CRP (2.1 versus 0.8 μg/ml, p<0.0005) and Wells score (3.2 versus 2.0, p<0.0001). For MP analysis, platelet-derived MP were found to differentiate DVT from negatives. Using multivariable logistic regression, a combination of sPsel and Wells score could establish the diagnosis of DVT (cut-point ≥90 ng/ml + Wells ≥2), with a specificity of 96% and positive predictive value (PPV) of 100%, and could exclude DVT diagnosis (cut-point ≤60 ng/ml and Wells <2) with a sensitivity of 99%, a specificity of 33% and a negative predictive value (NPV) of 96%. This study establishes a biomarker and clinical profile combination that can both confirm and exclude the diagnosis of DVT.
登录
查看更多内容
影响因子：
7.5
作者：
Weitz, Jeffrey I.
通讯作者：
Weitz, Jeffrey I.
影响因子：
39.2
作者：
Verhovsek, Madeleine;Douketis, James D.;Lim, Wendy
通讯作者：
Lim, Wendy
影响因子：
6.7
作者：
Hron, Gregor;Kollars, Marietta;Weltermann, Ansgar
通讯作者：
Weltermann, Ansgar
影响因子：
4.3
作者：
Myers, Daniel D., Jr.;Henke, Peter K.;Wakefield, Thomas W.
通讯作者：
Wakefield, Thomas W.
影响因子：
7.5
作者：
Ay, Cihan;Freyssinet, Jean-Marie;Pabinger, Ingrid
通讯作者：
Pabinger, Ingrid