摘要
目的深静脉血栓形成(DVT)与止血调节临床检验试验的关系。方法应用ELISA法检测72例DVT患者和20例正常对照者的内皮素-1(ET-1)、血栓调节蛋白(TM)、P-选择素(P-selectin)、凝血酶原片段1+2(F1+2)、凝血酶-抗凝血酶复合物(TAT)、血栓前体蛋白(TpP)和D-二聚体(D-D)。计算各试验的敏感性、特异性、阴性预期值、阳性预期值和准确性;通过计算ROC曲线下面积(AUCROC)比较各检验指标的诊断效率。结果除ET-1外,其余指标与正常对照组相比均有显著性差异(P<0.05);P-selectin、F1+2、TpP和D-D的AUCROC显著高于ET-1、TM和TAT(P<0.05),TpP具有最高的AUCROC,但与P-selectin、F1+2和D-D比较无显著性差异(P>0.05);在所有评价的指标中,TpP敏感性、阴性预期值和准确性最高,D-D特异性和阳性预期值最高。结论止血调节指标D-D和TpP水平的增加分别提示纤溶和凝血,二者联合检测为排除和诊断DVT提供了良好的实验室依据。
Objective To investigate the correlation tests in the regulation of hemostasis. Methods End between deep vein thrombosis（DVT） and clinical laboratory othelin-1 （ET-1） , thrombomodulin （TM） , P-selectin, prothrombin fragment 1＋2 （ F1＋2） , thrombin-antithrombin complex （TAT） , thrombus precursor protein （TpP） and D-Dimer （D-D） were measured in DVT patients （ n = 72） and normal individuals （ n = 20） with ELISA method. The sensitivity, specificity, negative predictive value （NPV） , positive predictive value （PPV） and accuracy were evaluated for each of the items, and the area of the underlying receiver operating characteristic curve （AUC^ROC） was used to appraise diagnostic efficiency. Results Except ET-1, there were significant differences between the DVT group and normal control group in the other items. The AUC^ROC of P-selectin, F1 ＋2, TpP and D-D was bigger than that of ET-1, TM and TAT （P 〈 0.05）. The AUC^ROC of TpP was the biggest, but there was no significant difference between P-selectin, F1＋2, TpP and D-D （P 〉 0.05）. The TpP had the highest sensitivity, NPV and accuracy, and the D-D had the highest specificity and PPV. Conclusion The increase of D-D and TpP could reflect the occurrence of continuous coagulation and fibrolysis respectively. Thus the combination of measuring TpP and D-D could provide better laboratory evidence for the diagnosis of patients with DVT.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2006年第1期78-80,83,共4页
Journal of Shanghai Jiao tong University:Medical Science
关键词
深静脉血栓形成
止血调节
检验试验
deep venous thrombosis
regulation of hemostasis
laboratory test
