Advertisement

Relevanz von D-Dimer in der Diagnostik der venösen Thrombose

  • C.-E. Dempfle
Conference paper

Zusammenfassung

Die Messung von D-Dimer erlaubt bei Patienten mit klinischen Zeichen einer venösen Thrombose oder Embolie eine Ausschlußdiagnostik, bei der 10–40% der Patienten von der Durchführung technischer Untersuchungen, wie Phlebographie, Sonographie und anderen Verfahren ausgeschlossen werden können. Gegenwärtig sind für diese Indikation nur quantitative Meßverfahren zu empfehlen, wobei die traditionellen Mikrotiterplatten-ELISA-Tests für die Anwendung als Notfalltests wenig praktikabel erscheinen. Neuere schnelle automatisierte Testverfahren zeigen den Mikrotiterplattentests vergleichbare Sensitivitäten bei hinreichender Spezifität und Geschwindigkeit.

Für das Screening von asymptomatischen postoperativen oder bettlägerigen Patienten sind quantitative D-Dimer-Tests ebenfalls einsetzbar, allerdings muß für jedes Patientenkollektiv ein eigener Referenzbereich ermittelt werden.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Boneu B, Bes G, Pelzer H, Sie P, Boccalon H (1991) D-dimers, thrombin antithrombin III complexes and prothrombin fragments 1+2: diagnostic value in clinically suspected deep vein thrombosis. Thromb Haemost 65: 28–31PubMedGoogle Scholar
  2. 2.
    Borg JY, Levesque H, Cailleux N et al. (1997) Rapid quantitative D-dimer test and clinical evaluation for the diagnosis of clinically suspected deep vein thrombosis [letter]. Thromb Haemost 77: 602–603PubMedGoogle Scholar
  3. 3.
    Bounameaux H, Khabiri E, Huber O et al. (1992) Value of liquid crystal contact thermography and plasma level of D-dimer for screening of deep venous thrombosis following general abdominal surgery. Thromb Haemost 67: 603–606PubMedGoogle Scholar
  4. 4.
    Bounameaux H, Schneider PA, Reber G et al. (1989) Measurement of plasma D-dimer for diagnosis of deep venous thrombosis. Am J Clin Pathol 91: 82–85PubMedGoogle Scholar
  5. 5.
    Brenner B, Pery M, Lanir N et al. (1995) Application of a bedside whole blood D-dimer test in the diagnosis of deep vein thrombosis. Blood Coagul Fibrinolysis 6: 219–222PubMedCrossRefGoogle Scholar
  6. 6.
    Carter CJ, Doyle DL, Dawson N, Fowler S, Devine DV (1993) Investigations into the clinical utility of latex D-dimer in the diagnosis of deep venous thrombosis. Thromb Haemost 69: 8–11, 24Google Scholar
  7. 7.
    Chang Liem GS, Lustermans FA, Wersch JW van (1991) Comparison of the appropriateness of the latex and Elisa plasma D-dimer determination for the diagnosis of deep venous thrombosis. Haemostasis 21: 106–110Google Scholar
  8. 8.
    Chapman CS, Akhtar N, Campbell S et al. (1990) The use of D-Dimer test by enzyme immunotest and latex agglutination techniques in the diagnosis of deep vein thrombosis. Clin Lab Haematol 12: 37–42PubMedCrossRefGoogle Scholar
  9. 9.
    Cofrancesco E, Cortellaro M, Corradi A et al. (1998) Clinical utility of prothrombin fragment F1+2, thrombin antithrombin III complexes, and D-dimer measurements in the diagnosis of deep vein thrombosis following total hip replacement. Thromb Haemost 79: 509–510PubMedGoogle Scholar
  10. 10.
    Crippa L, Ravasi F, D’Angelo SV et al. (1995) Diagnostic value of compression ultrasonography and fibrinogen-related parameters for the detection of postoperative deep vein thrombosis following elective hip replacement: a pilot study. Thromb Haemost 74: 1235–1239PubMedGoogle Scholar
  11. 11.
    Dale S, Gogstad GO, Brosstad F et al. (1994) Comparison of three D-dimer tests for the diagnosis of DVT: ELISA, latex and an immunofiltration test ( NycoCard D-Dimer ). Thromb Haemost 71: 270–274PubMedGoogle Scholar
  12. 12.
    D’Angelo A, D’Alessandro G, Tomassini L et al. (1996) Evaluation of a new rapid quantitative D-dimer test in patients with clinically suspected deep vein thrombosis. Thromb Haemost 75: 412–416PubMedGoogle Scholar
  13. 13.
    Douketis JD, McGinnis J, Ginsberg JS (1997) The clinical utility of a rapid bedside Ddimer test for screening of deep venous thrombosis following orthopedic surgery. Thromb Haemost 78: 1300–1301PubMedGoogle Scholar
  14. 14.
    Dunn ID, Hui AC, Triffitt PD et al. (1994) Plasma D-dimer as a marker for postoperative deep venous thrombosis. A study after total hip or knee arthroplasty. Thromb Haemost 72: 663–665PubMedGoogle Scholar
  15. 15.
    Elias A, Aptel I, Huc B et al. (1996) D-dimer test and diagnosis of deep vein thrombosis: a comparative study of 7 tests. Thromb Haemost 76: 518–522PubMedGoogle Scholar
  16. 16.
    Elms MJ, Bunce IH, Bundesen PG et al. (1983) Measurement of crosslinked fibrin degradation products–an immunotest using monoclonal antibodies. Thromb Haemost 50: 591–594PubMedGoogle Scholar
  17. 17.
    Freyburger G, Trillaud H, Labrouche S et al. (1998) D-dimer strategy in thrombosis exclusion. A gold standard study in 100 patients suspected of venous thrombosis or pulmonary embolism: 8 DD methods compared. Thromb Haemost 79: 32–37PubMedGoogle Scholar
  18. 18.
    Gaffney PJ, Edgell T, Creighton Kempsford LJ et al. (1995) Fibrin degradation product (FnDP) test: analysis of standardization issues and target antigens in plasma. Br J Haematol 90: 187–194PubMedCrossRefGoogle Scholar
  19. 19.
    Gaffney PJ, Joe F (1979) The lysis of crosslinked human fibrin by plasmin yields initially a single molecular complex, D-dimer-E. Thromb Res 15: 673–687Google Scholar
  20. 20.
    Harvey RL, Roth EJ, Yarnold PR, Durham JR, Green D (1996) Deep vein thrombosis in stroke. The use of plasma D-dimer level as a screening test in the rehabilitation setting [see comments]. Stroke 27: 1516–1520Google Scholar
  21. 21.
    Heaton DC, Billings JD, Hickton CM (1987) Assessment of D dimer tests for the diagnosis of deep vein thrombosis. J Lab Clin Med 110: 588–591PubMedGoogle Scholar
  22. 22.
    Heijboer H, Ginsberg JS, Buller HR et al. (1992) The use of the D-dimer test in combination with non-invasive testing vs. serial non-invasive testing alone for the diagnosis of deep-vein thrombosis. Thromb Haemost 67: 510–513PubMedGoogle Scholar
  23. 23.
    Janssen MC, Verbruggen BW, ter Hark PJ, Novakova IR (1997) Factor VIIA determination compared to D-dimer in diagnosis of deep venous thrombosis. Thromb Res 86: 423–426PubMedCrossRefGoogle Scholar
  24. 24.
    Janssen MC, Verbruggen H, Wollersheim H et al. (1997) D-dimer determination to assess regression of deep venous thrombosis. Thromb Haemost 78: 799–802PubMedGoogle Scholar
  25. 25.
    Killick SB, Pentek PG, Mercieca JE et al. (1997) Comparison of immunofiltration test of plasma D-Dimer with diagnostic imaging in deep vein thrombosis. Br J Haematol 96: 846–849PubMedCrossRefGoogle Scholar
  26. 26.
    Korte W, Lutz S, Bossart S. (1998) Comparison of new automated latex tests for D-dimer with ELISAs for the exclusion of deep venous thrombosis. Ann Hematol 76 (Suppl 1):A 88Google Scholar
  27. 27.
    Legnani C, Pancani C, Palareti G et al. (1997) Comparison of new rapid methods for D-dimer measurement to exclude deep vein thrombosis in symptomatic outpatients. Blood Coagul Fibrinol 8: 296–302CrossRefGoogle Scholar
  28. 28.
    Leroyer C, Escoffre M, Le Moigne E et al. (1997) Diagnostic value of a new sensitive membrane based technique for instantaneous D-dimer evaluation in patients with clinically suspected deep venous thrombosis. Thromb Haemost 77: 637–640PubMedGoogle Scholar
  29. 29.
    Mayer W, Hirschwehr R, Hippmann G et al. (1997) Whole-blood immunotest (SimpliRED) vs. plasma immunotest (NycoCard) for the diagnosis of clinically suspected deep vein thrombosis. Vasa 26: 97–101PubMedGoogle Scholar
  30. 30.
    Moerloose P de, Desmarais S, Bounameaux H et al. (1996) Contribution of a new, rapid, individual and quantitative automated D-dimer ELISA to exclude pulmonary embolism. Thromb Haemost 75: 11–13PubMedGoogle Scholar
  31. 31.
    Mossaz A, Gandrille S, Vitoux JF. (1990) [The value of D-dimer tests in the emergency diagnosis of venous thrombosis (letter)]. Presse Med 19: 1055Google Scholar
  32. 32.
    Ott P, Astrup L, Jensen RH, Nyeland B, Pedersen B (1988) Assessment of D-dimer in plasma: diagnostic value in suspected deep venous thrombosis of the leg. Acta Med Scand 224: 263–267PubMedCrossRefGoogle Scholar
  33. 33.
    Pannocchia A, Chiappino I, Valpreda S et al. (1996) DVT exclusion in symptomatic outpatients: use of a rapid D-dimer immunofiltration test and comparison with three enzyme immuno tests. Fibrinolysis 10 Suppl. 2: 117–119CrossRefGoogle Scholar
  34. 34.
    Pfitzner SA, Dempfle CE, Matsuda M, Heene DL (1997) Fibrin detected in plasma of patients with disseminated intravascular coagulation by fibrin-specific antibodies consists primarily of high molecular weight factor XIIIa-crosslinked and plasmin-modified complexes partially containing fibrinopeptide A. Thromb Haemost 78: 1069–1078PubMedGoogle Scholar
  35. 35.
    Rowbotham BJ, Carroll P, Whitaker AN et al. (1987) Measurement of crosslinked fibrin derivatives-use in the diagnosis of venous thrombosis. Thromb Haemost 57: 59–61PubMedGoogle Scholar
  36. 36.
    Rylatt DB, Blake AS, Cottis LE et al. (1983) An immuno test for human D dimer using monoclonal antibodies. Thromb Res 31: 767–778PubMedCrossRefGoogle Scholar
  37. 37.
    Scarano L, Bernardi E, Prandoni P et al. (1997) Accuracy of two newly described D-dimer tests in patients with suspected deep venous thrombosis. Thromb Res 86: 93–99PubMedCrossRefGoogle Scholar
  38. 38.
    Turkstra F, van Beek EJ, Cate JW ten, Buller HR (1996) Reliable rapid blood test for the exclusion of venous thromboembolism in symptomatic outpatients [see comments]. Thromb Haemost 76: 9–11PubMedGoogle Scholar
  39. 39.
    Van Bergen PF, Knot EA, Jonker JJ et al. (1989) Is quantitative determination of fibrin(ogen) degradation products and thrombin-antithrombin III complexes useful to diagnose deep venous thrombosis in outpatients? Thromb Haemost 62: 1043–1045PubMedGoogle Scholar
  40. 40.
    Wells PS, Brill Edwards P, Stevens P et al. (1995) A novel and rapid whole-blood test for D-dimer in patients with clinically suspected deep vein thrombosis. Circulation 91: 2184–2187PubMedGoogle Scholar
  41. 41.
    Whitaker AN, Elms MJ, Masci PP et al. (1984) Measurement of cross linked fibrin derivatives in plasma: an immunotest using monoclonal antibodies. J Clin Pathol 37: 882–887PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • C.-E. Dempfle

There are no affiliations available

Personalised recommendations