The clinical features of patients suffering from pulmonary embolism with negative D-dimer
10.3760/cma.j.issn.1671-0282.2011.08.017
- VernacularTitle:D-二聚体阴性肺栓塞患者的临床特点
- Author:
Xiaolei GU
;
Jinsong ZHANG
- Publication Type:Journal Article
- Keywords:
Pulmonary embolism;
D-dimer;
Clinical characters;
Differential diagnosis
- From:
Chinese Journal of Emergency Medicine
2011;20(8):851-855
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical features of patients suffering from pulmonary embolism (PE) with D-dimer ＜ 0. 5 μg/mL in order to raise the diagnostic accuracy and reduce the mortality rate of PE. MethodsD-dimer-negative patients with suspected PE were admitted from January 2006 through December 2009. A comparison of clinical features including clinical manifestations, vital signs, laboratory and ancillary findings between 16 patients finally diagnosed PE and 41 patients without PE. ResultsCompared with patients without PE, the D-dimer-negative patients with PE usually had past history of venous thromembolism (VTE) or recent surgery. The symptoms of chest tightness, acute dyspnea, tachypnea, lower extremity edema and typical S I QⅢTⅢ changes of ECG were more often occurred in patients with PE than those in patients without PE of control group. ConclusionsD-dimer test is a good screening test for acute PE because its negative predictive value is high, but when the patients have acute dyspnea, lower extremity edema, previous history of VTE or/and recent surgery and ECG SI QⅢ TⅢ changes, even if D -dimer ＜ 0. 5 μg/mL, clinicians also should pay attention to and if necessary, further tests should be considered to confirm the diagnosis of PE.
