Biomarkers for the diagnosis of deep vein thrombosis.

Expert opinion on medical diagnostics Pub Date : 2012-07-01 Epub Date: 2012-06-06 DOI:10.1517/17530059.2012.692674
Dawn M Coleman, Thomas W Wakefield
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引用次数: 19

Abstract

Venous thromboembolic disease (VTE) remains a significant source of morbidity and mortality. As non-specific subjective complaints and a paucity of objective clinical examination findings complicate the diagnosis of both deep venous thrombosis (DVT) and pulmonary embolism, diagnostic modalities remain essential. Compression ultrasound remains the gold standard for DVT diagnosis. Reliable imaging is not always available making a serologic diagnosis, or biomarker, highly desirable. While D-dimer, a highly sensitive biomarker, is useful for excluding acute VTE, it lacks the specificity necessary for diagnostic confirmation. As such, ongoing research efforts target and support the utility of alternative plasma biomarkers to aid in the diagnosis of VTE including selectins, microparticles, IL-10 and other inflammatory markers. These molecular markers may also predict recurrence risk, guide length and modality of treatment, and predict which thrombi will resolve spontaneously or recanalize, thus potentially identifying patients who would benefit from more aggressive therapies than standard anticoagulation.
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诊断深静脉血栓的生物标志物。
静脉血栓栓塞性疾病(VTE)仍然是发病率和死亡率的重要来源。由于非特异性主观主诉和缺乏客观临床检查结果使深静脉血栓形成(DVT)和肺栓塞的诊断复杂化,诊断方式仍然是必不可少的。压缩超声仍然是深静脉血栓诊断的金标准。可靠的影像并不总是可用的,因此血清学诊断或生物标志物是非常需要的。虽然d -二聚体是一种高度敏感的生物标志物,可用于排除急性静脉血栓栓塞,但它缺乏诊断确认所需的特异性。因此,正在进行的研究工作瞄准并支持替代血浆生物标志物的应用,以帮助诊断静脉血栓栓塞,包括选择素、微粒、IL-10和其他炎症标志物。这些分子标记物还可以预测复发风险、指导长度和治疗方式,并预测哪些血栓会自发消退或再通,从而潜在地确定哪些患者将受益于比标准抗凝治疗更积极的治疗。
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