CAJ | 학술논문

　　目的探讨64排螺旋CT肺血管造影联合血浆D-二聚体在诊断肺动脉血栓栓塞症（肺栓塞，pulmonary thromboembloism，PTE）诊断中的价值。方法疑诊肺栓塞的患者243例进行心电图、动脉血气分析、胸部正侧片、心脏彩超及下肢彩色多普勒检查血清D-二聚体和螺旋CT肺血管造影检查,明确最终诊断肺栓塞病例数，并分别计算以探讨螺旋CT肺血管造影联合D-二聚体检查的敏感性与特异性等，分析螺旋CT肺血管造影结合D-二聚体对PTE的诊断价值。结果103例患者确诊为PTE，140例排除。D-二聚体敏感性97.1%、特异性62.8%，64排螺旋CT肺血管造影检查敏感性84.8%，特异性为96.7%,两者结合诊断的灵敏度和特异性分别提高到89.3％和83.5％。结论64排螺旋CT肺血管造影结合D-二聚体可提高对诊断PTE的灵敏度和特异性，减少漏诊、误诊，在PTE的及时诊治中具有很好的临床应用价值。
　　목적탐토64배라선CT폐혈관조영연합혈장D-이취체재진단폐동맥혈전전새증（폐전새，pulmonary thromboembloism，PTE）진단중적개치。방법의진폐전새적환자243례진행심전도、동맥혈기분석、흉부정측편、심장채초급하지채색다보륵검사혈청D-이취체화라선CT폐혈관조영검사,명학최종진단폐전새병례수，병분별계산이탐토라선CT폐혈관조영연합D-이취체검사적민감성여특이성등，분석라선CT폐혈관조영결합D-이취체대PTE적진단개치。결과103례환자학진위PTE，140례배제。D-이취체민감성97.1%、특이성62.8%，64배라선CT폐혈관조영검사민감성84.8%，특이성위96.7%,량자결합진단적령민도화특이성분별제고도89.3％화83.5％。결론64배라선CT폐혈관조영결합D-이취체가제고대진단PTE적령민도화특이성，감소루진、오진，재PTE적급시진치중구유흔호적림상응용개치。
Objective To evaluate the 64-row spiral CT pulmonary angiography combined with plasma D-dimer in the diagnosis of pulmonary thromboembolism (pulmonary embolism and pulmonary thromboembloism, PTE) value in the diagnosis. Methods 243 cases patients with suspected diagnosis of pulmonary embolism in electrocardiogram (ecg), arterial blood gas analysis, positive side chest, heart colour to exceed, and lower color doppler examination of serum D-dimer and spiral CT pulmonary angiography, the ifnal diagnosis of pulmonary embolism cases clearly, and calculated separately in order to investigate the spiral CT pulmonary angiography combined with D-dimer check the sensitivity and speciifcity, such as analysis of spiral CT pulmonary angiography combined withD-dimer value to the diagnosis of PTE. Results 103 patients diagnosed with PTE, 140 cases ruled out.D-dimer sensitivity 97.1%,specificity 62.8%,64-row spiral CT pulmonary angiography sensitivity 84.8%, specificity of 96.7%, the diagnostic sensitivity and specificity of the combination increased to 89.3% and 89.3%respectively. Conclusion 64-row spiral CT pulmonary angiography combined withD-dimer can improve the sensitivity and speciifcity of the diagnosis of PTE, reduce missed diagnosis and misdiagnosis, in PTE timely diagnosis and treatment has good clinical application value.