Author/Editor		Blinc, Aleš; Šabovič, Mišo; Videčnik, Viktor; Fras, Zlatko; Finderle, Žare; Košir, Dušica; Poredoš, Pavel; Stegnar, Mojca
Title		Aglutinacijski test iz kapilarne krvi za določanje D-dimera v diagnostiki venske tromboze udov
Translated title		Whole blood agglutination assay for D-dimer in diagnostics of deep vein thrombosis of the limbs
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 10
Publication year		2000
Volume		str. 673-7
Language		slo
Abstract		Background. Ultrasonographic diagnostics of deep vein thrombosis is accurate, but time-consuming because of the need for repeated assessment. Several authors have reported that measurement of D-dimer, a specific degradation product of fibrin, can simplify the diagnostic procedure. Patients and methods. Commercially available rapid whole blood agglutination test for D-dimer (SimpliRed) was evaluated in 90 patients referred to our laboratory for ultrasonographic assessment of suspected proximal vein thrombosis of the lower limb (83 patients) or upper limb (7 patients). The agglutination test for D-dimers was performed in all patients on the first day of the examination. Ultrasonography of the lower or upper limb veins was performed on the first day and repeated on the 2nd-4th day and on the 5th-7th day if the previous ultrasonographic findings were negative. The test for D-dimer was evaluated in the diagnostics of proximal limb vein thrombosis with respect to the standard ultrasonographic examination. Results. Proximal vein thrombosis of the lower limb was ultrasonographically confirmed in 29 out of 83 patients and proximal venous thrombosis of the upper limb in 4 out of 7 patients.The test for D-dimer was truly positive in 31 patients and falsely negative in 2 out of 33 patients with proximal vein thrombosis. The D-dimer assay was truly negative in 35 patients and falsely positive in 22 patients. Among the latter there were patients who had undergone surgery or arthroscopy shortly prior to the examination for venous thrombosis, some had clinical signs of erisypelas or haematoma in the calf, and one patient had sepsis. The sensitivity of the Simpli-Red whole blood agglutination test for D-dimer in diagnosing proximal vein thrombosis of the limb was 94%, the specificity 61%, the positive predictive value 58% and the negative predictive value 94% (Abstract truncated at 2000 characters.)
Summary		Izhodišča. Ultrazvočna diagnostika venske tromboze je zanesljiva, vendar zamudna zaradi potrebe po ponavljanju preiskave. Tuji avtorji poročajo, da lahko z določanjem specifičnega razgradnega produkta fibrina, D-dimera, poenostavimo diagnostični postopek pri sumu na vensko trombozo. Preiskovanci in metode. Pri 90 bolnikih s kliničnim sumom na proksimalno vensko trombozo spodnjih udov (83 bolnikov) ali zgornjih udov (7 bolnikov) smo v diagnostičnem postopku poleg standardne ultrazvočne preiskave ven pri prvem pregledu uporabili tudi hitro aglutinacijo preiskavo na D-dimer iz kapilarne krvi (SimpliRed). Ultrazvočno preiskavo ven smo izvedli pri prvem pregledu in pri negativnem ultrazvočnem izvidu tudi 2.-4. dan ter 5.-7. dan. Test na D-dimer smo ovrednotili glede na standardno ultrazvočno preiskavo. Rezultati. Proksimalno vensko trombozo spodnjih udov smo ultrazvočno potrdili pri 29 od 83 bolnikov in proksimalno vensko trombozo zgornjih udov pri 4 od 7 bolnikov. Test na D-dimer je bil pozitiven pri 31 od 33 bolnikov s potrjeno vensko trombozo udov, pri dveh pa lažno negativen. Pravilno negativen test na D-dimer smo izmerili pri 35 bolnikih, lažno pozitiven pa pri 22 bolnikih, med katerimi so nekateri preiskovanci kratek čas pred pregledom prestali operativni ali artroskopski poseg, imeli klinične znake šena ali hematoma v goleni, en preiskovanec pa je imel sepso. Občutljivost testa na D-dimer v diagnostiki venske tromboze je tako znašala 94%, specifičnost 61%, pozitivna napovedana vrednost 58% in negativna napovedana vrednost 94%. Zaključki. Zaključujemo, da je določanje D-dimera z aglutinacijskim testom kapilarne krvi dobra preiskava za izključevanje venske tromboze, pozitiven rezultat testa pa zaradi široke diferencialne diagnoze stanj s povečano koncentracijo D-dimera nima diagnostične vrednosti.
Descriptors		THROMBOPHLEBITIS FIBRIN FIBRINOGEN DEGRADATION PRODUCTS AGGLUTINATION TESTS