Author/Editor		Škrgat-Kristan, Sabina; Meško-Brguljan, Pika; Košnik, Mitja; Šorli, Jurij
Title		D-dimer v diagnostiki pljučne embolije
Translated title		D-dimer in the diagnostic procedure of pulmonary embolism
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 68, št. 11
Publication year		1999
Volume		str. 639-41
Language		slo
Abstract		Background. D-dimer concentration is increased in pulmonary embolism (PE), deep vein thrombosis (DVT) and in many other diseases and conditions. In this study the usefulness of plasma D-dimer concentration measurement was assessed in differential diagnosis in patients with dyspnoea and suspected pulmonary embolism. Methods. In retrospective analysis 144 patients were included who had been examined due to dyspnoea. We measured their plasma D-dimer concentration with immunoturbidimetric test Turbiquant D-dimer (Behring Diagnostic GmbH). D-dimer concentration above 250 ug/L was considered as increased. Forty-one patients had also their plasma D-dimer concentration measured with SimpliRED D-dimer (AGEN Biomedical) test simultaneously. Patients with increased D-dimer concentration were classified into 8 groups, according to their final diagnosis. Diagnostic values of both tests were compared. Results. Among 144 patients there were 38 (26,4%) with D- dimer concentration 250 ug/L or less. Two of them had pulmonary embolism. One hundred and six (73. 6%)patients had D- dimer concentration above 250 ug/L. There was no statistical difference in concentration of D-dimer between the PE group and other groups of patients (p > 0.05). In 19 patients with negative SimpliRED D-dimer but positive Turbiquant D-dimer test, concentration of D-dimer was between 253 and 2640 ug/L. Conclusions. Values of D-dimer concentration above the cutoff value are of no help in differential diagnosis in patients with dyspnoea and suspected pulmonary embolism. Values of D-dimer concentration below cutoff value exclude pulmonary embolism with 95% probability. Cutoff value of SimpliRED D-dimer test isprobably higher than cutoff value of Turbiquant D-dimer test.
Summary		Izhodišča. Koncentracija D-dimera se poveča pri pljučni emboliji (PE), globoki venski trombozi (GVT) ter pri številnih drugih boleznih in stanjih. Želeli smo ugotoviti diagnostično vrednost določanja koncentracije D-dimera v diferencialni diagnostiki bolnikov z dispnejo in sumom na PE. Metode. V retrospektivno analizo smo vključili 144 bolnikov, ki smo jih v sprejemni ambulanti Klinike za pljučne bolezni in alergijo obravnavali zaradi dispneje. Bolnikom smo koncentracijo D-dimera v plazmi določili s turbidimetričnim testom Turbiquant D-dimer (Behring Diagnostic GmbH). Koncentracijo D-dimera prek 250 ug/L smo vzeli za povečano. Pri 41 bolnikih smo hkrati uporabili tudi SimpliRED D-dimer (AGEN Biomedical) aglutinacijski test iz polne krvi. Bolnike s povečano koncentracijo D-dimera smo razdelili v 8 skupin glede na njihove odpustne diagnoze. Primerjali smo diagnostični vrednosti testov Turbiquant D-dimer in SimpliRED D-dimer. Rezultati. Med 144 bolniki jih je imelo 38 (26,4%) koncentracijo D-dimera 250 ug/L in manj. Med njimi sta bila dva bolnika s pljučno embolijo. Bolnikov s koncentracijo D-dimera nad 250 ug/L je bilo 106 (73, 6%). Med bolniki s PE in bolniki ostalih skupin ni bilo statistično pomembnih razlik (p > 0, 05). Pri 19 bolnikih, ki so imeli test SimpliRED D-dimer negativen in test Turbiquant D-dimer pozitiven, je bila koncentracija D - dimera v območju med 253 in 2640 ug/L. Zaključki. Povečana koncentracija D-dimera nam v diferencialni diagnostiki bolnikov z dispnejo in sumom na PE ni v pomoč. Koncentracija D-imera pod mejno vrednostjo pa s 95% verjetnostjo izključuje PE. Kaže, da je mejna vrednost testa SimpliRED D-dimer verjetno nekoliko višja od mejne vrednosti testa Turbiquant D-dimer.
Descriptors		PULMONARY EMBOLISM FIBRIN FIBRINOGEN DEGRADATION PRODUCTS DYSPNEA BLOOD CHEMICAL ANALYSIS SLOVENIA FIBRINOLYSIS THROMBOPHLEBITIS