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J Thromb Haemost:年龄调整的D-二聚体排除深静脉血栓形成!

2017-11-14 xing.T MedSci原创

由此可见,使用年龄调整后D-二聚体的PALLADIO算法所需的影像学检查次数略有减少,但这种方法应在大型研究中来进行证实。

为了提高静脉血栓栓塞(VTE)诊断的特异性,研究人员提出了年龄调整的D-二聚体。然而,这个阈值的准确性最近受到了质疑。血栓和凝血疾病权威杂志Journal of Thrombosis and Haemostasis上发表了一篇研究文章,研究人员旨在评估年龄调整后的D-二聚体联合临床验前概率(PTP)对可疑深静脉血栓形成(DVT)患者的诊断价值。

PALLADIO研究(NCT01412242)是一个多中心管理的研究,旨在验证了一种新的诊断方法,包括PTP、D-二聚体(使用厂商的临界值)以及门诊临床疑似DVT个体的局限或扩大压缩超声(CUS)。受试者被分为三组,即不太可能的PTP和阴性D-二聚体的DVT患者没有进一步的检查就予以排除(第1组);可能的PTP或D-二聚体阳性接受了有限的CUS患者(第2组);可能的PTP和D-二聚体阳性接受了扩展的CUS患者(第3组)。研究人员对基线时因患有DVT而被排除的患者进行了3个月的随访。在事后分析中,研究人员评估了年龄调整后的D-二聚体临界值(在年龄超过50岁的患者中,定义为D-二聚体是年龄的10倍μg/L,或年龄的5倍μg/L)。

该研究共招募了1162名患者。初诊时,第2组患者中4%的患者检测出了DVT,第3组患者中53%的患者发现了DVT。年龄调整后的D-二聚体,相对于固定的临界值,导致CUS减少5.1%(95%可信区间为4.0-6.5 %)。在随访期间,第1组患者有症状的VTE发病率为0.24%(95%可信区间为0.04-1.37);第2组为1.12%(95%可信区间为0.44-2.85);第3组为1.89%(95%可信区间为0.64-5.40)。

由此可见,使用年龄调整后D-二聚体的PALLADIO算法所需的影像学检查次数略有减少,但这种方法应在大型研究中来进行证实。

原始出处:


Nicoletta Riva.et al. Age-adjusted D-dimer to rule out deep vein thrombosis: findings from the PALLADIO algorithm.Journal of Thrombosis and Haemostasis.2017. http://onlinelibrary.wiley.com/doi/10.1111/jth.13905/full

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    2018-08-15 changfy
  2. [GetPortalCommentsPageByObjectIdResponse(id=2008318, encodeId=847a20083185b, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Wed Aug 15 21:29:00 CST 2018, time=2018-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331182, encodeId=dfb0331182ac, content=有没有具体的调整后参考值啊?, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=981b2401455, createdName=12355bb4m53(暂无昵称), createdTime=Fri Jul 13 00:02:41 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697575, encodeId=2a19169e5750d, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sun Oct 28 05:29:00 CST 2018, time=2018-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955327, encodeId=a552195532e85, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sun Aug 19 08:29:00 CST 2018, time=2018-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950355, encodeId=82db195035528, content=<a href='/topic/show?id=bfc624041dc' target=_blank style='color:#2F92EE;'>#二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24041, encryptionId=bfc624041dc, topicName=二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Thu Jan 04 20:29:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310846, encodeId=5fc7131084606, content=<a href='/topic/show?id=b15c5628e9' target=_blank style='color:#2F92EE;'>#D-二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5628, encryptionId=b15c5628e9, topicName=D-二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e093393, createdName=luwei00, createdTime=Thu Nov 16 13:29:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483259, encodeId=224a1483259b1, content=<a href='/topic/show?id=c82e991e71b' target=_blank style='color:#2F92EE;'>#静脉血栓形成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Thu Nov 16 13:29:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261356, encodeId=3f7c2613566c, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Nov 15 00:04:54 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261346, encodeId=30f326134634, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Tue Nov 14 22:48:45 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2018-07-13 12355bb4m53(暂无昵称)

    有没有具体的调整后参考值啊?

    0

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    2018-10-28 fusion
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    2018-08-19 xue8602
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    2018-01-04 hxj0117
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  7. [GetPortalCommentsPageByObjectIdResponse(id=2008318, encodeId=847a20083185b, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Wed Aug 15 21:29:00 CST 2018, time=2018-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331182, encodeId=dfb0331182ac, content=有没有具体的调整后参考值啊?, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=981b2401455, createdName=12355bb4m53(暂无昵称), createdTime=Fri Jul 13 00:02:41 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697575, encodeId=2a19169e5750d, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sun Oct 28 05:29:00 CST 2018, time=2018-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955327, encodeId=a552195532e85, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sun Aug 19 08:29:00 CST 2018, time=2018-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950355, encodeId=82db195035528, content=<a href='/topic/show?id=bfc624041dc' target=_blank style='color:#2F92EE;'>#二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24041, encryptionId=bfc624041dc, topicName=二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Thu Jan 04 20:29:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310846, encodeId=5fc7131084606, content=<a href='/topic/show?id=b15c5628e9' target=_blank style='color:#2F92EE;'>#D-二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5628, encryptionId=b15c5628e9, topicName=D-二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e093393, createdName=luwei00, createdTime=Thu Nov 16 13:29:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483259, encodeId=224a1483259b1, content=<a href='/topic/show?id=c82e991e71b' target=_blank style='color:#2F92EE;'>#静脉血栓形成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Thu Nov 16 13:29:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261356, encodeId=3f7c2613566c, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Nov 15 00:04:54 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261346, encodeId=30f326134634, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Tue Nov 14 22:48:45 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=2008318, encodeId=847a20083185b, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Wed Aug 15 21:29:00 CST 2018, time=2018-08-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=331182, encodeId=dfb0331182ac, content=有没有具体的调整后参考值啊?, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=981b2401455, createdName=12355bb4m53(暂无昵称), createdTime=Fri Jul 13 00:02:41 CST 2018, time=2018-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697575, encodeId=2a19169e5750d, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Sun Oct 28 05:29:00 CST 2018, time=2018-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955327, encodeId=a552195532e85, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sun Aug 19 08:29:00 CST 2018, time=2018-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950355, encodeId=82db195035528, content=<a href='/topic/show?id=bfc624041dc' target=_blank style='color:#2F92EE;'>#二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24041, encryptionId=bfc624041dc, topicName=二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Thu Jan 04 20:29:00 CST 2018, time=2018-01-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310846, encodeId=5fc7131084606, content=<a href='/topic/show?id=b15c5628e9' target=_blank style='color:#2F92EE;'>#D-二聚体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5628, encryptionId=b15c5628e9, topicName=D-二聚体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e093393, createdName=luwei00, createdTime=Thu Nov 16 13:29:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1483259, encodeId=224a1483259b1, content=<a href='/topic/show?id=c82e991e71b' target=_blank style='color:#2F92EE;'>#静脉血栓形成#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99177, encryptionId=c82e991e71b, topicName=静脉血栓形成)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1d387907505, createdName=ms5187542471278033, createdTime=Thu Nov 16 13:29:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261356, encodeId=3f7c2613566c, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Wed Nov 15 00:04:54 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=261346, encodeId=30f326134634, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Tue Nov 14 22:48:45 CST 2017, time=2017-11-14, status=1, ipAttribution=)]
    2017-11-15 飛歌

    学习了很有用

    0

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    2017-11-14 惠映实验室

    学习了.谢谢.

    0

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