实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2014年
10期
19-21,22
,共4页
肺栓塞%预测%诊断%Wells评分%修正的Geneva评分%肺动脉造影
肺栓塞%預測%診斷%Wells評分%脩正的Geneva評分%肺動脈造影
폐전새%예측%진단%Wells평분%수정적Geneva평분%폐동맥조영
Pulmonary embolism%Forecasting%Diagnosis%Wells score%Revised Geneva score%Computed tomo-graphy pulmonary angiography
目的：评价 Wells 评分与修正的 Geneva 评分对肺栓塞的预测价值。方法连续选择2009年12月-2012年12月在我院住院的疑诊肺栓塞患者153例，均进行 Wells 评分与修正的 Geneva 评分，以肺动脉造影（CTPA）检查结果作为诊断肺栓塞的“金标准”。结果经 CTPA 检查确诊肺栓塞78例，Wells 评分预测低度、中度、高度可能肺栓塞的符合率分别为0、49.5%、82.1%，修正的 Geneva 评分预测低度、中度、高度可能肺栓塞的符合率分别为33.3%、55.3%、90.9%。绘制 ROC 曲线发现，Wells 评分预测肺栓塞的曲线下面积（ AUC）为0.770〔95% CI （0.696，0.844）〕，修正的 Geneva 评分为0.733〔95% CI（0.653，0.813）〕，差异无统计学意义（P >0.05）。Wells 评分预测肺栓塞的最佳临界值为3.5分，此时的灵敏度为76.9%，特异度为66.7%；修正的 Geneva 评分预测肺栓塞的最佳临界值为5.5分，此时的灵敏度为60.3%，特异度为82.7%。结论 Wells 评分与修正的 Geneva 评分均对肺栓塞有良好的预测价值，可根据患者情况选用或联合应用。
目的：評價 Wells 評分與脩正的 Geneva 評分對肺栓塞的預測價值。方法連續選擇2009年12月-2012年12月在我院住院的疑診肺栓塞患者153例，均進行 Wells 評分與脩正的 Geneva 評分，以肺動脈造影（CTPA）檢查結果作為診斷肺栓塞的“金標準”。結果經 CTPA 檢查確診肺栓塞78例，Wells 評分預測低度、中度、高度可能肺栓塞的符閤率分彆為0、49.5%、82.1%，脩正的 Geneva 評分預測低度、中度、高度可能肺栓塞的符閤率分彆為33.3%、55.3%、90.9%。繪製 ROC 麯線髮現，Wells 評分預測肺栓塞的麯線下麵積（ AUC）為0.770〔95% CI （0.696，0.844）〕，脩正的 Geneva 評分為0.733〔95% CI（0.653，0.813）〕，差異無統計學意義（P >0.05）。Wells 評分預測肺栓塞的最佳臨界值為3.5分，此時的靈敏度為76.9%，特異度為66.7%；脩正的 Geneva 評分預測肺栓塞的最佳臨界值為5.5分，此時的靈敏度為60.3%，特異度為82.7%。結論 Wells 評分與脩正的 Geneva 評分均對肺栓塞有良好的預測價值，可根據患者情況選用或聯閤應用。
목적：평개 Wells 평분여수정적 Geneva 평분대폐전새적예측개치。방법련속선택2009년12월-2012년12월재아원주원적의진폐전새환자153례，균진행 Wells 평분여수정적 Geneva 평분，이폐동맥조영（CTPA）검사결과작위진단폐전새적“금표준”。결과경 CTPA 검사학진폐전새78례，Wells 평분예측저도、중도、고도가능폐전새적부합솔분별위0、49.5%、82.1%，수정적 Geneva 평분예측저도、중도、고도가능폐전새적부합솔분별위33.3%、55.3%、90.9%。회제 ROC 곡선발현，Wells 평분예측폐전새적곡선하면적（ AUC）위0.770〔95% CI （0.696，0.844）〕，수정적 Geneva 평분위0.733〔95% CI（0.653，0.813）〕，차이무통계학의의（P >0.05）。Wells 평분예측폐전새적최가림계치위3.5분，차시적령민도위76.9%，특이도위66.7%；수정적 Geneva 평분예측폐전새적최가림계치위5.5분，차시적령민도위60.3%，특이도위82.7%。결론 Wells 평분여수정적 Geneva 평분균대폐전새유량호적예측개치，가근거환자정황선용혹연합응용。
Objective To evaluate the predictive value of Wells score and revised Geneva score on pulmonary embol-ism. Methods A total of 153 cases suspected as pulmonary embolism were collected in our hospital from December 2009 to De-cember 2012. They were evaluated by Wells score and revised Geneva score,and pulmonary arteriography(CTPA)results was served as golden standard for pulmonary embolism. Results By CTPA results,78 cases were diagnosed as pulmonary embol-ism. Coincidence rate of Wells score in predicting the low - possibility,middle - possibility and high - possibility of pulmonary embolism was 0,49. 5% ,82. 1% ,respectively;that of revised Geneva score was 33. 3% ,55. 3% ,90. 9% ,respective-ly. ROC curve showed that,AUC of Wells score in predicting pulmonary embolism was 0. 770〔95% CI(0. 696,0. 844)〕, that of revised Geneva score was 0. 733〔95% CI(0. 653,0. 813)〕,the difference was not significantly different(P > 0. 05). The best threshold of Wells score in predicting pulmonary embolism was 3. 5,and the sensitivity was 76. 9% ,the specificity was 66. 7% ;the best threshold of revised Geneva score in predicting pulmonary embolism was 5. 5,and the sensitivity was 60. 3% , the specificity was 82. 7% . Conclusion Both of Wells score and revised Geneva score have certain predictive value on pulmona-ry embolism,the choice to make is depending on patient's clinical situation,or joint them together.
