目的：分析健康人群和住院患者血浆D-二聚体水平随年龄增长的变化特征，探讨不同年龄段血浆D-二聚体排除诊断老年人静脉血栓栓塞（VTE）的临界值。方法选择健康体检者6717例和住院患者2976例。采用法国生物梅里埃VIDAS荧光免疫分析仪测定血浆D-二聚体水平。结果40岁以上健康人群随年龄增长，血浆D-二聚体水平显著增高（P<0.01），住院患者各年龄组血浆D-二聚体水平存在同样变化趋势，VTE发生率也随年龄增加而增加。D-二聚体诊断≤40岁组患者VTE的临界值为504μg/L，敏感度为100.0%；41~60岁组的临界值为565μg/L，敏感度为96.2%；61~74岁组的临界值为817μg/L，敏感度为80.8%；≥75岁组的临界值为1024μg/L，敏感度为73.1%。结论血浆D-二聚体水平随年龄的增长而增高，老年患者D-二聚体排除诊断VTE的临界值高于其他年龄组，但诊断敏感度显著下降。%Objective To investigate the plasma level of D-dimer in healthy population and hospitalized patients, and to analyze the cut-off value of D-dimer levels in different age groups for the exclusion of venous thromboembolism (VTE) in older patients. Methods A total of 6 717 healthy individuals and 2 976 hospitalized patients were included in the study. The blood level of D-dimer was detected by the Biomerieux VIDAS fluor-euzymelinked immunoassay analyzer assay. Results The blood level of D-dimer was significantly increased with age in healthy people aged over 40 and different age groups of hospitalized patients (P<0.01). The incidence of venous thromboembolism was also increased with age. The cut-off value for the diagnosis of VTE with D-dimer was 504 μg/L in patient group aged ≤40 years, and the sensitivity was 100.0%. The cut-off value was 565μg/L in 41~60-year group, and the sensitivity was 96.2%. The cut-off value was 817μg/L in 61~74-year group, and the sensitivity was 80.8%. The cut-off value was 1 024μg/L in≥75-year group, and the sensitivity was 73.1%. Conclusion The plasma D-dimer level increased with age. The D-dimer cur-off value was higher in older patients than that of other age groups, but the sensitivity in diagnosis was decreased obviously.
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