CAJ | 학술논문

　　目的评价修正Geneva评分与Daniel心电图评分对肺栓塞的诊断价值，并探讨两者联用后对肺栓塞诊断的敏感度及特异度的影响。方法疑似肺栓塞患者41例，分别获得修正Geneva评分分值与及Daniel心电图评分分值，再进行肺动脉CTA检查以确诊。应用ROC曲线比较两者对肺栓塞的诊断价值，并观察联合应用后诊断肺栓塞的敏感度及特异度。结果修正Geneva评分对肺栓塞的最佳诊断分值为5分，以≥5分预测肺栓塞，敏感度85.7%，特异度92.3%。Daniel心电图评分对肺栓塞诊断的最佳分值为2分，以≥2分预测肺栓塞，敏感度83.1%，特异度76.9%。修正Geneva评分的AUC为0.870±0.060（P＜0.001，95%CI：0.752～0.987）。Daniel心电图评分诊断肺栓塞的AUC为0.875±0.065（P=0.002，95%CI：0.748～1.002，Z=1.016，P＞0.05）。结论修正Geneva评分与Daniel心电图评分对肺栓塞均有良好的诊断价值（AUC均在0.7～0.9），但无差异，两者合用可提高肺栓塞诊断的敏感度。
　　목적평개수정Geneva평분여Daniel심전도평분대폐전새적진단개치，병탐토량자련용후대폐전새진단적민감도급특이도적영향。방법의사폐전새환자41례，분별획득수정Geneva평분분치여급Daniel심전도평분분치，재진행폐동맥CTA검사이학진。응용ROC곡선비교량자대폐전새적진단개치，병관찰연합응용후진단폐전새적민감도급특이도。결과수정Geneva평분대폐전새적최가진단분치위5분，이≥5분예측폐전새，민감도85.7%，특이도92.3%。Daniel심전도평분대폐전새진단적최가분치위2분，이≥2분예측폐전새，민감도83.1%，특이도76.9%。수정Geneva평분적AUC위0.870±0.060（P＜0.001，95%CI：0.752～0.987）。Daniel심전도평분진단폐전새적AUC위0.875±0.065（P=0.002，95%CI：0.748～1.002，Z=1.016，P＞0.05）。결론수정Geneva평분여Daniel심전도평분대폐전새균유량호적진단개치（AUC균재0.7～0.9），단무차이，량자합용가제고폐전새진단적민감도。
Objective To evaluate the value of revised Geneva scores and Daniel ECG scores, alone or in combina-tion, in diagnosis of pulmonary embolism (PE). Methods The revised Geneva scores and Daniel ECG scores were ob-tained and pulmonary CTA was performed in 41 cases with suspected PE. ROC was used to evaluate the value of these two scores in diagnosis of PE. Results PE was confirmed by pulmonary CTA in 28 cases. The revised Geneva score 5 points predicted PE with a sensitivity of 85.7%and specificity of 92.3%.Daniel ECG score 2 points predicted PE with a sensitivity of 83.1% and specificity of 76.9%.The area under curve (AUC)of the ROC curve of the revised Geneva scores and Daniel ECG scores were 0.870 ±0.060 (95%CI:0.752~0.987) (P<0.001) and 0.875 ±0.065 (95%CI:0.748~1.002)(P=0.002), respectively. Conclusion The revised Geneva scores and Daniel ECG scores are beneficial to predict PE. The sensitivity for PE diagnosis can be improved by the two methods combined.