中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
11期
65-66
,共2页
肺栓塞%D-二聚体%肺动脉造影
肺栓塞%D-二聚體%肺動脈造影
폐전새%D-이취체%폐동맥조영
Pulmonary thromboembolism%D-dimer%CT pulmonary angiography
目的 探讨血浆D-二聚体及CT肺血管造影对肺血栓栓塞(PTE)的诊断价值.方法 选择2008年1月至2014年5月枣庄市立医院疑似PTE的患者68例,确诊的33例PTE患者为观察组,余35例非肺栓塞患者为对照组,所有患者均现行D-二-聚体检查,随后128排螺旋CT肺血管造影检查(CTPA),对两组D-二聚体值及CTPA表现进行统计学分析,比较敏感性、特异性和最后诊断.结果 研究组D-二聚体＞500 μg/L 32例,＜500 μg/L 1例;阳性率(敏感性)和阴性率分别为97％和3％.35例非肺栓塞患者血浆D-二聚体阳性率与阴性率(即特异性)分别为60％和40％,两组阴性率差异有统计学意义(P＜0.01).33例PTE患者CTPA阳性31例,敏感性为93.9％,阴性率为6.1％.35例非肺栓塞组患者CTPA阳性2例,阴性33例,阴性率(即特异性)为94.3％,两组比较差异有统计学意义(P＜0.01).结论 D-二聚体阳性不能单独诊断肺栓塞,D-二聚体阴性仍有肺栓塞可能.低特异性的D-二聚体和CTPA联合检查有助于提高PTE的诊断正确率,可作为肺栓塞诊断的主要方法,临床可基本代替肺动脉造影检查.
目的 探討血漿D-二聚體及CT肺血管造影對肺血栓栓塞(PTE)的診斷價值.方法 選擇2008年1月至2014年5月棘莊市立醫院疑似PTE的患者68例,確診的33例PTE患者為觀察組,餘35例非肺栓塞患者為對照組,所有患者均現行D-二-聚體檢查,隨後128排螺鏇CT肺血管造影檢查(CTPA),對兩組D-二聚體值及CTPA錶現進行統計學分析,比較敏感性、特異性和最後診斷.結果 研究組D-二聚體＞500 μg/L 32例,＜500 μg/L 1例;暘性率(敏感性)和陰性率分彆為97％和3％.35例非肺栓塞患者血漿D-二聚體暘性率與陰性率(即特異性)分彆為60％和40％,兩組陰性率差異有統計學意義(P＜0.01).33例PTE患者CTPA暘性31例,敏感性為93.9％,陰性率為6.1％.35例非肺栓塞組患者CTPA暘性2例,陰性33例,陰性率(即特異性)為94.3％,兩組比較差異有統計學意義(P＜0.01).結論 D-二聚體暘性不能單獨診斷肺栓塞,D-二聚體陰性仍有肺栓塞可能.低特異性的D-二聚體和CTPA聯閤檢查有助于提高PTE的診斷正確率,可作為肺栓塞診斷的主要方法,臨床可基本代替肺動脈造影檢查.
목적 탐토혈장D-이취체급CT폐혈관조영대폐혈전전새(PTE)적진단개치.방법 선택2008년1월지2014년5월조장시립의원의사PTE적환자68례,학진적33례PTE환자위관찰조,여35례비폐전새환자위대조조,소유환자균현행D-이-취체검사,수후128배라선CT폐혈관조영검사(CTPA),대량조D-이취체치급CTPA표현진행통계학분석,비교민감성、특이성화최후진단.결과 연구조D-이취체＞500 μg/L 32례,＜500 μg/L 1례;양성솔(민감성)화음성솔분별위97％화3％.35례비폐전새환자혈장D-이취체양성솔여음성솔(즉특이성)분별위60％화40％,량조음성솔차이유통계학의의(P＜0.01).33례PTE환자CTPA양성31례,민감성위93.9％,음성솔위6.1％.35례비폐전새조환자CTPA양성2례,음성33례,음성솔(즉특이성)위94.3％,량조비교차이유통계학의의(P＜0.01).결론 D-이취체양성불능단독진단폐전새,D-이취체음성잉유폐전새가능.저특이성적D-이취체화CTPA연합검사유조우제고PTE적진단정학솔,가작위폐전새진단적주요방법,림상가기본대체폐동맥조영검사.
Objective To investigate the diagnostic value of CT pulmonary angiography and plasma D-dimer on pulmonary thromboembolism(PTE).Methods Sixty-eight suspected PTE patients were selected from January 2008 to May 2014,33 PTE patients diagnosed as the observation group,35 cases of non pulmonary embolism patients remaining as the control group,all the patients were performed D-dimer examination and the 128 row CTPA,and the data of two groups were analyzed statistically,compared the sensitivity,specificity and final diagnosis.Results Thirty-two cases of study group D-dimer ＞500 μg/L,D-dimer ＜500 μg/L in 1 case; positive rate (sensitivity) and the negative rate was 97％ and 3％.Positive rate and the negative rate (specific) of 35 cases of non pulmonary embolism patients plasma-was 60％ and 40％,there was significant difference in the negative rate between the two groups(P ＜ 0.01).Thirty-one PTE patients with CTPA positive expression,the sensitivity was 93.9％,the negative rate was 6.1％.Two cases in patients with non CTPA group showed positive results,33 cases were negative,the negative rate (specific) was 94.3％,there was significant difference between the two groups (P ＜ 0.01).Conclusions Whether D-dimer is positive or negative can not diagnose or exclude pulmonary embolism.The low specificity of D-dimer combined with CTPA examination is helpful to improve the diagnostic accuracy of PTE,can be used as the main method in the diagnosis of pulmonary embolism,and can replace the pulmonary artery angiography.
