D-二聚体在肺栓塞中的应用-英文课件

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1、D-dimerinPulmonaryembolismThe1stHospitalOfJilinUniversityZhenggiuWangOutlineD-dimerassaysMethodsD-dimercut-offandAgeD-dimerandClinicalProbabilityD-dimerandanticoagulationD-dimerinOtherdiseasesFormationofD-dimerPartIFormationofD-dimerPartIID-dimerMethods※Sensitivityandspecif

2、icityofdifferentD-dimerassaysRoleofD-dimerinVTE;ImagingDecisions3/2007※D-dimerMethodsPartIIID-dimerandClinicalProbabilityinSuspectedPED-dimerandClinicalProbabilityinSuspectedPEAcutePulmonaryEmbolism；CurrProblCardiol2010;35:314-376.ArchInternMed.2004;164:2483-2487※D-dimerand

3、ClinicalProbabilityinSuspectedPE※Thecut-offofD-dimerinVTEArchInternMed.2004;164:2483-2487D-dimerandClinicalProbabilityinSuspectedPEPartIVD-dimerandanticoagulation※D-dimerconcentrationandanticoagulanttherapyNEJM2006;355;1780-9;D-dimerTestingtoDeterminetheDurationofAnticoagul

4、ationTherapy曲线1曲线2曲线3PartIVD-dimerandanticoagulationBaselinecharacteristics：年纪更大、并发症更多、随访时间更长PartIVD-dimerandanticoagulationFigure3.Cumulativeincidenceandhazardratios(HRs)ofmainoutcomesaccordingtoD-dtimecoursefromthethirdmonth(T90)tothe13thmonth(T390).Group1:PatientsinwhomD

5、-dwasnormalatT90andafterward(withD-dbecomingabnormalonlyonce).Group2:PatientsinwhomD-dbecameabnormalatT90andafterwardremainedalteredpersistentlyoratleasttwice.Group3:PatientsinwhomD-dbecameabnormalafterT90andafterwardremainedabnormalpersistentlyoratleasttwice.NEJM,356;4;Jan

6、uary2007;D-dimerandanticoagulation※Thecut-offofD-dimerinVTE※D-dimerandrecurrentVTEPartIID-dimerandAge※D-dimerandrecurrentVTE※D-dimerandrecurrentVTEPartVD-dimercut-offandAgeD-dimerinPulmonaryembolismThe1stHospitalOfJilinUniversityAcutePulmonaryEmbolism；CurrProblCardiol2010;3

7、5:314-376.AcutePulmonaryEmbolism；CurrProblCardiol2010;35:314-376.FatalPEaccordingtoAgeFigure1:DistributionofD-dimerresultsforagegroups(a)<40years,(b)40-60years(c)60-80years,and(d)>80years.AD-dimerresultisreportedasnegativeifbelow500ng/ml,showedbyboldventicalline.※D-dimerass

8、ayintheelderlyInternalMedicineJournal37(2007)607-613※D-dimerandAge※D-dimerandAge※D