FIBRIN DEGRADATION PRODUCT D-DIMER IN THE DIAGNOSIS OF PULMONARY-EMBOLISM

被引:23
作者
LICHEY, J [1 ]
RESCHOFSKI, I [1 ]
DISSMANN, T [1 ]
PRIESNITZ, M [1 ]
HOFFMANN, M [1 ]
LODE, H [1 ]
机构
[1] FREE UNIV BERLIN,KLINIKUM STEGLITZ,INNERE MED ABT,W-1000 BERLIN 45,GERMANY
来源
KLINISCHE WOCHENSCHRIFT | 1991年 / 69卷 / 12期
关键词
PULMONARY EMBOLISM; D-DIMER;
D O I
10.1007/BF01649289
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The study objective was to determine the specificity and sensitivity of plasma concentrations of D-dimer, a fibrin degradation product, as a marker for ongoing thrombotic and thrombolytic events in pulmonary embolism. A prospective study was performed in 74 patients with suspected pulmonary embolism who appeared in the emergency room with dyspnea and/or chest pain. The presence of pulmonary embolism was established by positive findings either in pulmonary angiography or lung scan. D-dimer concentrations were determined in all patients. In 11 patients with positive pulmonary angiography, D-dimer concentrations were monitored for 6-12 days. D-dimer concentrations were determined by a quantitative enzyme-linked immunoassay. Plasma probes of 26 patients (16 with/10 without positive pulmonary angiography) were reassayed with a semiquantitative latex agglutination assay. D-dimer levels were significantly higher in patients with pulmonary embolism (> 1000 ng/mL in 41 out of 43) than in those without (< 1000 ng/mL in all 21 patients) (p < 0.01). The sensitivity and specificity for the ELISA were found to be 95% and 100%, respectively, for establishing the diagnosis of pulmonary embolism. In the latex assay the values were 81% and 60%, respectively. It is concluded that in patients with dyspnea and/or chest pain, determination of D-dimer in plasma by ELISA adds a valuable tool to the non-invasive diagnostic procedure for pulmonary embolism. From the time-course of D-dimer values we conclude that this assay might be valuable up to at least 6 days after symptom onset. The assay, however, is unreliable in malignancies or after surgery.
引用
收藏
页码:522 / 526
页数:5
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