目的：确定血浆D-二聚体诊断早期弥散性血管内凝血（DIC）的最佳临界值。方法收集易引发DIC的疾病患者200例，应用免疫比浊法测定D-二聚体含量，建立受试者工作特征（ROC）曲线，确定针对DIC诊断的最佳临界值。结果确定D-二聚体诊断DIC患者的最佳临界值为4.5，其敏感性为61.5%，特异性为78.3%，阳性预测值为40.7%，阴性预测值为89.4%，曲线下面积为0.702。结论只有合理确定D-二聚体诊断DIC患者的最佳临界值，才能有效保证检测结果的科学性及适用性，为临床诊断提供有效帮助。%Objective To determine the optimal critical value of plasma D-dimer in the diagnosis of previously disseminated intravascular coagulation (DIC). Methods Samples from 200 patients with different diseases which easily lead to DIC were collected. D-dimer test was done by immunonephelometry method. Receiver operating characteristic (ROC) curve was applied to determine the optimal critical value of plasma D-dimer for the diagnosis of DIC. Results The optimal critical value of D-dimer for diagnosis of DIC was 4.5. Sensitivity, specificity, positive and negative predictive values were 61.5%, 78.3%, 40.7%and 89.4%respectively. The area under the ROC curve was 0.702 (confidence interval 0.599~0.805). Conclusion The optimal critical value of plasma D-dimer in the diagnosis of DIC can provide the effective help for clinical diagnosis and ensure the results to be scientific and suitable for clinical application.
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