The value of fibrin monomer combined with Wells′ score in early diagnosis of venous thromboembolic disease
10.3760/cma.j.issn.1009-9158.2017.08.008
- VernacularTitle:纤维蛋白单体联合Wells评分对静脉血栓栓塞性疾病的早期诊断价值
- Author:
Qi LI
;
Hairun YAN
;
Hong JIN
;
Yan ZHAO
;
Zhengliang YANG
- Keywords:
Venous thromboembolism;
Venous thrombosis;
Fibrin fibrinogen degradation products
- From:
Chinese Journal of Laboratory Medicine
2017;40(8):589-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the change of the fibrin monomer (FM) level in the venous thromboembolic disease (VTE).To compare the diagnostic value of FM combined Wells score with the other detection methods.Methods In this case control study,121 cases were selected from the patients who were from general and orthopeadic surgery (including thrombosis group in 60 cases and non thrombosis group in 61 cases).The patients were assessed by Wells score.From one day before surgery, Plasma d-dimer (D-D) and fibrin monomer (FM) were periodic measured by CP-2000 d-dimer and fibrin monomer.Evaluation the value of d-dimer,fibrin monomer and fibrin monomer combined with Wells score in diagnosis of venous thromboembolic disease.The receiver operation cure(ROC) was drew to determine the diagnostic performance.Results The plasma FM level of patients with VTE in the thrombus group (26.11±38.34) μg/ml is higher than the non thrombus group (6.56±6.81) μg/ml and the control group (2.37±0.89) μg/ml (t=-3.82, t=-4.78,P<0.01);the sensitivity of FM was lower than the D-D (85% vs 93%);then the positive predictive value was lower than D-D (82% vs 87%) (χ2=27.01,P=0.000)but its specificity and negative predictive value (65%) are both higher than D-D (65% vs 44%)(71% vs 62%)(χ2=11.67,P=0.001);the sensitivity,the specificity,the positive predictive value and the negative predictive value of FM combined Wells score are increased (90%,85%,83%,89%)(χ2=20.95,χ2=16.65,P<0.01).The increased level of FM is earlier than imaging changes, and the elevated of plasma D-D is not obvious in a certain period of time.Conclusions The sensitivity and specificity of FM combined with Wells′ score is higher in the diagnosis of VTE, its prediction value in the diagnosis of VTE is higher.The FM level can be changed in the early stage of VTE, which has a certain value of early diagnosis.
