DIAGNOSTIC EFFICACY OF THE D-DIMER ASSAY IN DISSEMINATED INTRAVASCULAR COAGULATION (DIC)
DIAGNOSTIC EFFICACY OF THE D-DIMER ASSAY IN DISSEMINATED INTRAVASCULAR COAGULATION (DIC)
复制标题
DOI：
10.1016/0049-3848(92)90116-r
复制
发表时间：
1992-03-15
影响因子：
7.5
通讯作者：
BAKER, WF
中科院分区：
文献类型：
--
作者：
BICK, RL;BAKER, WF
用于测量交联纤维蛋白降解产物的D-二聚体（D-D）检测试剂盒现已可用于临床实验室。 我们将该检测与其他检测相结合，以评估诊断或疑似DIC的患者。 此外，研究了一小组（20）深静脉血栓形成（DVT）患者。 采用D-D试验、抗凝血酶-III试验、FDP滴度、纤维蛋白肽-A水平、硫酸鱼精蛋白试验、纤维蛋白原、凝血酶原时间和活化部分凝血活酶时间。 DIC患者D-D试验异常率为93.7%，AT-Ⅲ异常率为87.5%，纤维蛋白肽A异常率为89.5%，FDP滴度升高率为83.7%。 当评估未确诊DIC的患者时，20%的D-D测定异常，6%的AT-III水平异常，13%的纤维蛋白肽-A水平升高。 我们的结论是D-二聚体测定是一个有用的分子标记物的止血诊断DIC和这个测试往往会区分那些患者与或不DIC，特别是当使用AT-III和纤维蛋白肽-A测定。 在本研究中使用的一系列测试中，按疗效降序排列，最有用的似乎是D-二聚体测定（93.7%异常）、纤维蛋白肽-A滴度（89.5%异常）、AT-III水平（87.5%异常）和FDP滴度（83.7%异常）。 在全球试验中，凝血酶原时间活化部分凝血活酶时间和硫酸鱼精蛋白试验的诊断有效性不大于偶然性，似乎在辅助诊断DIC方面用处不大。 此外，D-二聚体测定的成本与FDP滴度相似，对于常规临床实验室而言具有成本效益。
The D-Dimer (D-D) assay for measuring cross-linked fibrin degradation products is now available for the clinical laboratory. We combined this assay with other tests to assess patients with diagnosed or suspected DIC. Also, a small group of patients (20) with deep venous thrombosis (DVT) were studied. The D-D test, antithrombin-III assay, FDP titer, fibrinopeptide-A level, protamine sulfate test, fibrinogen, prothrombin time, and activated partial thromboplastin time were used. The D-D test was abnormal in 93.7%, the AT-III level was abnormal in 87.5%, the fibrinopeptide-A level was abnormal in 89.5%, and the FDP titer was elevated in 83.7% of patients with DIC. When assessing patients found not to have confirmed DIC the D-D assay was abnormal in 20%, the AT-III level was abnormal in 6%, and the fibrinopeptide-A level was elevated in 13%. We conclude the D-Dimer assay to be a useful molecular marker of hemostasis in diagnosing DIC and this test will often discriminate between those patients with or without DIC, especially when used with the AT-III and fibrinopeptide-A assays. Of the battery of tests used in this study, the most useful, in descending order of efficacy, appear to be the D-dimer assay (93.7% abnormal), the fibrinopeptide-A titer (89.5% abnormal), the AT-III level (87.5% abnormal), and the FDP titer (83.7% abnormal). Of the global tests, the diagnostic efficacy of the prothrombin time activated partial thromboplastin time, and protamine sulfate test were no greater than chance and appear to be of little use in aiding in a diagnosis of DIC. Also, the D-Dimer assay is similar in cost to the FDP titer and is cost effective for the routine clinical laboratory.