medicina59巻8号

2022年07月発行

特集 日常診療に潜む臨床検査のピットフォールを回避せよ 各論 ＜血液・凝固・線溶系検査＞

Case 5．D-ダイマー正常の大動脈解離？

著者： 原田拓¹

所属機関： ¹練馬光が丘病院総合診療科

ページ範囲：P.1236 - P.1239

症例
50代男性
主　訴　胸痛

参考文献

1）Shimony A, et al：Meta-analysis of usefulness of d-dimer to diagnose acute aortic dissection. Am J Cardiol 107：1227-1234, 2011

2）Lippi G, et al：Causes of elevated D-dimer in patients admitted to a large urban emergency department. Eur J Intern Med 25：45-48, 2014

3）Weitz JI, et al：A test in context；D-dimer. J Am Coll Cardiol 70：2411-2420, 2017

4）Potu KC, et al：A primer on diagnostic and financial implications of D-dimer testing. S D Med 69：414-417, 2016

5）Hazui H, et al：Young adult patients with short dissection length and thrombosed false lumen without ulcer-like projections are liable to have false-negative results of D-dimer testing for acute aortic dissection based on a study of 113 cases. Circ J 70：1598-1601, 2006

6）Yang G, et al：Characteristics and prognosis of acute type A aortic dissection with negative D-dimer result. Am J Emerg Med 38：1820-1824, 2020

7）Nitta K, et al：Impact of a negative D-dimer result on the initial assessment of acute aortic dissection. Int J Cardiol 258：232-236, 2018

8）Nazerian P, et al：Diagnostic accuracy of the aortic dissection detection risk score plus D-dimer for acute aortic syndromes；The ADvISED prospective multicenter study. Circulation 137：250-258, 2018