目的 探讨D-二聚体与股动脉彩色多普勒超声联合检测对下肢静脉血栓患者的治疗和预后的指导意义.方法 选择下肢静脉血栓患者170例,对其进行D-二聚体及股动脉彩色多普勒超声检测.将血浆D-二聚体浓度大于或等于1000 μg/L判定为阳性患者,对彩色多普勒超声检测结果为阴性但血浆D-二聚体测定为阳性的患者进行二次彩色多普勒超声检测;对全部患者进行下肢静脉造影检测.结果 合并肺栓塞组患者D-二聚体含量显著高于无肺栓塞组(P<0.05);混合型下肢静脉血栓患者的D-二聚体阳性率及溶栓前后D-二聚体含量均显著高于周围型、中央型患者(P<0.05);通过将彩色多普勒超声与血浆D-二聚体浓度两种检测方法相结合,中央型、周围型及混合型下肢静脉血栓患者检测的灵敏度均大大增加.结论 D-二聚体的联合股动脉彩超检测增加了下肢静脉血栓的特异性以及灵敏度,对于下肢静脉血栓患者的治疗和预后具有指导意义.%Objective To investigate the directive significance of combination detection of D-dimer and femoral artery color dopplar ultrasound in treatment and prognossis evaluation of patients with lower limb venous thrombosis.Methods One hundred and seventy patients with lower limb venous thrombosis who were treated in our hospital were enrolled in the study. These patients were examined by D-dimer combined with femoral artery color Dopplar ultrasound. The patients with the concentration of plasma D-dimer >1,000μg/L were regarded as positive patients. The patients whose examination results of color Doppler ultrasound were negative and the detection results of D dimer were positive should have a second detection.All the patients received lower limb venography detection. Results The levels of D-dimer in patients with lower limb venous thrombosis complicated by pulmonary embolism were significantly higher than those of patients with simple lower limb venous thrombosis (P<0.05).The positive rate of D dimer and D-dimer levels before and after thrombolysis in patients with mixed type lower limb venous thrombosis were significantly higher than those of patients with peripheral and central type lower limb venous thrombosis (P<0.05).The combination detection of color Dopplar ultrasound and plasma levels of D-dimer could increase the sensitivity of detecting the central type,peripheral type and mixed type lower limb venous thrombosis.Conclusion The combination detection of color Dopplar ultrasound and plasma levels of D-dimer can increase the specificity and sensitivity of detection of lower limb venous thrombosis,which has directive significance in the treatment and prognosis evaluation of patients with lower limb venous thrombosis.
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