北京大学医学部机构知识库
Advanced  
IR@PKUHSC  > 北京大学第三临床医学院  > 急诊科  > 期刊论文
学科主题: 临床医学
题名:
Normal blood D-dimer concentrations: do they exclude pulmonary embolism?
作者: Guo Zhiguo; Ma Qingbian; Zheng Yaan; Zhang Yumei; Ge Hongxia
关键词: pulmonary embolism ; diagnosis ; D-dimer
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2014-01-05
DOI: 10.3760/cma.j.issn.0366-6999.20131681
卷: 127, 期:1, 页:18-22
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: CLINICAL PROBABILITY ASSESSMENT ; DEEP-VEIN THROMBOSIS ; THROMBOEMBOLIC DISEASE ; VENOUS THROMBOEMBOLISM ; DIAGNOSIS ; EMERGENCY ; ASSAY ; MANAGEMENT ; ACCURACY
英文摘要:

Background Although pulmonary embolism (PE) with normal blood D-dimer (DD) concentrations is considered rare, in practice the incidence may be greater than is generally believed. Overlooking PE is potentially dangerous. The aim of this study was to explore the incidence and clinical features of PE with normal DD concentrations.

Methods We retrospectively analyzed the records of 29 patients with PE and normal DD concentrations from the past seven years. We here compare relevant clinical characteristics of these patients with those of patients with PE and abnormal DD concentrations. We evaluated the probabilities of differences by computing pretest probability scores (Wells score and revised Geneva score).

Results The frequency of normal DD concentrations in patients with PE was 4%. Previous episode(s) of PE were more common in patients with normal DD concentrations than in those with abnormal DD concentrations (P=0.001). Fever, tachycardia, and tachypnea occurred less frequently in the former group (P<0.05) and time between onset of symptoms and DD testing was longer (P=0.001). The diagnosis of PE was delayed in 22 of the 29 cases. Nineteen and seven cases with normal DD concentrations were classified according to pretest scores as intermediate and low risk, respectively.

Conclusions PE with normal DD concentrations is uncommon. Although most diagnoses of PE are ruled out by normal DD values, a small number of cases with PE are missed. A combination of pretest probability score and normal DD concentration increases the probability of making the correct diagnosis, but cannot completely exclude patients with suspected PE. When the clinical manifestations cannot be otherwise explained, clinicians should be alert to the possibility of PE with normal DD concentrations in patients with previous episode(s) of PE or a long interval between onset of symptoms and DD testing.

语种: 英语
WOS记录号: WOS:000330606800004
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/53085
Appears in Collections:北京大学第三临床医学院_急诊科_期刊论文

Files in This Item:

There are no files associated with this item.


作者单位: Peking Univ, Hosp 3, Dept Emergency Med, Beijing 100191, Peoples R China

Recommended Citation:
Guo Zhiguo,Ma Qingbian,Zheng Yaan,et al. Normal blood D-dimer concentrations: do they exclude pulmonary embolism?[J]. CHINESE MEDICAL JOURNAL,2014,127(1):18-22.
Service
Recommend this item
Sava as my favorate item
Show this item's statistics
Export Endnote File
Google Scholar
Similar articles in Google Scholar
[Guo Zhiguo]'s Articles
[Ma Qingbian]'s Articles
[Zheng Yaan]'s Articles
CSDL cross search
Similar articles in CSDL Cross Search
[Guo Zhiguo]‘s Articles
[Ma Qingbian]‘s Articles
[Zheng Yaan]‘s Articles
Related Copyright Policies
Null
Social Bookmarking
Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit
所有评论 (0)
暂无评论
 
评注功能仅针对注册用户开放,请您登录
您对该条目有什么异议,请填写以下表单,管理员会尽快联系您。
内 容:
Email:  *
单位:
验证码:   刷新
您在IR的使用过程中有什么好的想法或者建议可以反馈给我们。
标 题:
 *
内 容:
Email:  *
验证码:   刷新

Items in IR are protected by copyright, with all rights reserved, unless otherwise indicated.

 

 

Valid XHTML 1.0!
Copyright © 2007-2017  北京大学医学部 - Feedback
Powered by CSpace