中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
23期
10488-10491
,共4页
赵蒙%玄超%夏瑞琴%伦立民
趙矇%玄超%夏瑞琴%倫立民
조몽%현초%하서금%륜립민
肺栓塞%D-二聚体%免疫比浊%诊断价值
肺栓塞%D-二聚體%免疫比濁%診斷價值
폐전새%D-이취체%면역비탁%진단개치
Pulmonary embolism%D-dimer%Immunological turbidimetry%Diagnostic value
目的：探讨血浆 D-二聚体对对疑似肺栓塞患者的诊断价值。方法采用自动化免疫比浊法测定患者血浆D-二聚体水平。统计分析血浆D-二聚体诊断肺栓塞的敏感性、特异性、阴性及阳性预测值，并绘制ROC曲线以评价其诊断价值并对D-二聚体阴性排除肺栓塞价值进行分析。结果在317例疑似肺栓塞患者中D-二聚体＜500μg/L的患者73例，其中6例被诊断为肺栓塞。D-二聚体对肺栓塞的诊断的敏感性为95.86%（95%CI：91.27%～98.08%），特异性为38.95%（95%CI：31.98%～41.41%），阴性预测值为91.78%（95%CI：83.21%～96.18%），阳性预测值为56.97%（95%CI：50.69%～63.02%），诊断准确性为64.98%（95%CI：59.58%～70.03%）。ROC曲线下面积为0.674（95%CI：0.615～0.733）。结论 D-二聚体对肺栓塞的诊断具有较高的敏感性，阴性排除肺栓塞的准确性较高，但仍可受患者年龄、测试方法等的影响。
目的：探討血漿 D-二聚體對對疑似肺栓塞患者的診斷價值。方法採用自動化免疫比濁法測定患者血漿D-二聚體水平。統計分析血漿D-二聚體診斷肺栓塞的敏感性、特異性、陰性及暘性預測值，併繪製ROC麯線以評價其診斷價值併對D-二聚體陰性排除肺栓塞價值進行分析。結果在317例疑似肺栓塞患者中D-二聚體＜500μg/L的患者73例，其中6例被診斷為肺栓塞。D-二聚體對肺栓塞的診斷的敏感性為95.86%（95%CI：91.27%～98.08%），特異性為38.95%（95%CI：31.98%～41.41%），陰性預測值為91.78%（95%CI：83.21%～96.18%），暘性預測值為56.97%（95%CI：50.69%～63.02%），診斷準確性為64.98%（95%CI：59.58%～70.03%）。ROC麯線下麵積為0.674（95%CI：0.615～0.733）。結論 D-二聚體對肺栓塞的診斷具有較高的敏感性，陰性排除肺栓塞的準確性較高，但仍可受患者年齡、測試方法等的影響。
목적：탐토혈장 D-이취체대대의사폐전새환자적진단개치。방법채용자동화면역비탁법측정환자혈장D-이취체수평。통계분석혈장D-이취체진단폐전새적민감성、특이성、음성급양성예측치，병회제ROC곡선이평개기진단개치병대D-이취체음성배제폐전새개치진행분석。결과재317례의사폐전새환자중D-이취체＜500μg/L적환자73례，기중6례피진단위폐전새。D-이취체대폐전새적진단적민감성위95.86%（95%CI：91.27%～98.08%），특이성위38.95%（95%CI：31.98%～41.41%），음성예측치위91.78%（95%CI：83.21%～96.18%），양성예측치위56.97%（95%CI：50.69%～63.02%），진단준학성위64.98%（95%CI：59.58%～70.03%）。ROC곡선하면적위0.674（95%CI：0.615～0.733）。결론 D-이취체대폐전새적진단구유교고적민감성，음성배제폐전새적준학성교고，단잉가수환자년령、측시방법등적영향。
Objective To study the diagnostic value of D-Dimer for patients suspected of pulmonary embolism(PE). Methods D-dimer levels were determined by rapid quantitative automated turbidimetric immunoassay. To evaluate the diagnostic performances of the D-dimer testing, sensitivity, specificity, negative predictive values, positive predictive values, accuracy and their 95%confidence intervals (95%CI) were calculated according to standard methods for proportions. The ROC curve analysis was also performed. Results Among the 73 patients out of 352 (25.3%) suspected PE patients that had a D-dimer level below 500 ng/ml, six patients had a confirmed PE according to the diagnosis strategy. Sensitivity of D-dimer assays reached 95.86% (95% CI:91.27%-98.08%) and specificity was 38.95% (95% CI: 31.98%-41.41%); negative predictive value reached 91.78% (95% CI: 83.21%-96.18%) and positive predictive value was 56.97% (95% CI: 50.69%-63.02%); the accuracy was 64.98%(95% CI: 59.58%-70.03%). The under area of ROC was 0.674(95% CI: 0.615-0.733). Conclusion The plasma D-dimer has high sensitivity in diagnosis of PE. But the age of patients, test method of D-dimer etc. may affect the sensitivity.
