High Plasma D-Dimer is a Marker of Deep Vein Thrombosis in Acute Stroke
详细信息 查看全文
- 作者：Takahiro Kuwashiro ; MD&lowast ; ; Kazunori Toyoda ; MD&lowast ; ; toyoda@hsp.ncvc.go.jp ; Naoki Oyama ; MD&lowast ; ; Kayoko Kawase ; MD&lowast ; ; Shuhei Okazaki ; MD&lowast ; ; Keiko Nagano ; MD&lowast ; ; Masatoshi Koga ; MD&lowast ; ; Hiroshi Matsuo ; MD&dagger ; ; Hiroaki Naritomi ; MD&lowast ; ; Kazuo Minematsu ; MD&lowast ;
- 关键词：Venous thromboembolism ; ultrasonography ; ischemic stroke ; cerebral infarction ; intracerebral hemorrhage
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2012
- 出版时间：April, 2012
- 年：2012
- 卷：21
- 期：3
- 页码：205-209
- 全文大小：141 K
文摘
This study investigated whether plasma D-dimer level is useful for detection of deep vein thrombosis (DVT) in patients with acute stroke. A total of 133 patients hospitalized within 3 days after stroke onset underwent duplex venous ultrasonographic examination of the lower limbs and repeated measurements of plasma D-dimer level. DVT was detected in 36 of 100 patients with ischemic stroke and in 25 of 33 patients with intracerebral hemorrhage (ICH) (76 % ; P < .001). Plasma D-dimer level on admission (7.5 ¡À 10.7 ¦Ìg/mL vs 3.7 ¡À 10.1 ¦Ìg/mL; P = .040) and its maximum level before the ultrasonographic examination (29.1 ¡À 48.7 ¦Ìg/mL vs 5.5 ¡À 11.0 ¦Ìg/mL; P < .001) were higher in the patients with DVT compared with those without DVT. On multivariate logistic regression analysis, the maximum D-dimer level was independently related to the identification of DVT (odds ratio [OR] 1.05; 95 % confidence interval [CI], 1.00-1.09 per 1-¦Ìg/mL increase; P = .045), but the admission D-dimer level was not when it was included instead of the maximum D-dimer level. In addition, female sex (OR, 4.99), ICH (OR, 5.20), high Wells clinical score (OR, 2.40 per 1-point increase), and low protein level (OR, 0.21 per 1-g/dL increase) were independently related to the identification of DVT. The optimum cutoff value of the maximum D-dimer level for positive DVT was 5.5 ¦Ìg/mL (sensitivity, 89 % ; specificity, 82 % ). Our findings suggest that high plasma D-dimer level during the course of acute stroke can help detect DVT on duplex venous ultrasonography.