CAJ | 학술논문

目的：探讨D-二聚体（ D-D）与纤维蛋白原（ Fg）联合检测对肺血栓栓塞（ PE）的临床诊断价值。方法共入选521例高度疑似PE的患者，其中住院后确诊为PE的284例；其他疾病对照组237例，包括冠心病心功能不全103例，高血压心功能不全65例，I型呼吸衰竭69例；同时设50例正常健康对照。 D-D、Fg测定分别采用免疫比浊法和Cluass凝固法，在STAGOSTA Compact全自动血凝分析仪上进行。结果 PE患者D-D与Fg水平明显高于正常对照组，差异具有显著性意义（P＜0．01），与疾病对照组比较差异无显著性意义（P＞0．05）。 D-D诊断PE的敏感性为91．19％，特异性为63．07％，阳性预测值与阴性预测值分别为70．95％和87．86％。 Fg对PE诊断的敏感性与特异性分别为71．13％和66．89％，阳性预测值与阴性预测值分别为68．01％和70．07％。 D-D与Fg联合检测对PE 诊断的敏感性与特异性分别为93．31％和60．28％，阳性预测值与阴性预测值分别为69．92％和90．10％。结论 D-D与Fg联合检测可以作为诊断肺栓塞首选筛选试验应用于临床。
목적：탐토D-이취체（ D-D）여섬유단백원（ Fg）연합검측대폐혈전전새（ PE）적림상진단개치。방법공입선521례고도의사PE적환자，기중주원후학진위PE적284례；기타질병대조조237례，포괄관심병심공능불전103례，고혈압심공능불전65례，I형호흡쇠갈69례；동시설50례정상건강대조。 D-D、Fg측정분별채용면역비탁법화Cluass응고법，재STAGOSTA Compact전자동혈응분석의상진행。결과 PE환자D-D여Fg수평명현고우정상대조조，차이구유현저성의의（P＜0．01），여질병대조조비교차이무현저성의의（P＞0．05）。 D-D진단PE적민감성위91．19％，특이성위63．07％，양성예측치여음성예측치분별위70．95％화87．86％。 Fg대PE진단적민감성여특이성분별위71．13％화66．89％，양성예측치여음성예측치분별위68．01％화70．07％。 D-D여Fg연합검측대PE 진단적민감성여특이성분별위93．31％화60．28％，양성예측치여음성예측치분별위69．92％화90．10％。결론 D-D여Fg연합검측가이작위진단폐전새수선사선시험응용우림상。
Objective To study the combined diagnostic value of D -two dimer ( D-D) and fibrinogen ( Fg) in detection of pulmonary embolism .Methods Totally 521 patients with suspected pulmonary embolism ( PE ) were recruited in the study.Among them, 284 patients were diagnosed with PE after hospitalization and 237 patients were diagnosed with other diseases ( disease control group ) including cardiac insufficiency with coronary heart disease in 103 patients , cardiac insuffi-ciency with hypertension in 65 patients, and type I respiratory failure in 69 patients.50 healthy persons were used as nor-mal control .D-D and Fg were measured by immune turbidimetry and Cluass solidification method , respectively , using the STAGOSTA Compact automatic blood coagulation analyzer .Results PE patients had significantly higher D -D and Fg lev-els compared to normal control group (P<0.01).But the two measurements are similar between PE patients and disease control group (P>0.05).The diagnostic sensitivity of D -D for PE was 91.19%, the specificity was 63.07%, positive and negative predictive values were 70.95% and 87.86%, respectively.The diagnostic sensitivity of Fg for PE was 71.13%, the specificity was 66.89%, positive and negative predictive values were 68.01% and 70.07%, respectively. The diagnostic sensitivity and specificity of combined D -D and Fg for PE were 93.31%and 60.28%, positive and nega-tive predictive values were 69.92%and 90.10%, respectively.Conclusion The combined detection of D -D and Fg can be used clinically as the preferred screening test for the diagnosis of pulmonary embolism.