CAJ | 학술논문

目的探讨D-Dimer、C-反应蛋白和脑钠肽在肺栓塞患者的临床诊断价值以及灵敏度、特异度和准确度对比研究.方法随机选取2013年5月~2014年5月间收治的大面积肺栓塞患者45例,小面积肺栓塞患者45例,并选取同期体检的健康者45例作为对照组.检测并比较治疗前后各组血浆D-Dimer、CRP和BNP水平.采用Logistic分析患者血浆D-Dimer、CRP和BNP水平与肺栓塞发生的相关性.以肺栓塞检验金标准(肺动脉造影)分别与D-dimer检验、CRP检验和BNP检验法做配对卡方检验,计算D-dimer检验、CRP检验和BNP检验3种检测方法的灵敏度、特异度和准确度,并比较其差异.结果治疗前,大面积组和小面积组肺栓塞D-Dimer、CRP和BNP水平均显著高于对照组(P<0.05);大面积组D-Dimer、CRP和BNP水平也明显高于小面积组(P<0.05).治疗后,大面积组和小面积患者血浆D-Dimer、CRP和BNP水平明显下降(P<0.05) ,且与正常对照组比较,差异无统计学意义.Logistic分析结果表明,血浆D-Dimer、CRP和BNP水平与肺栓塞的发生呈正相关性(r=3.11,P<0.05; r=4.36,P<0.05; r=2.86, P<0.05).D-Dimer检测、CRP检测和BNP检测方法在检测灵敏度、特异度和准确度方面差异无统计学意义.结论 D-dimer、C-反应蛋白和脑钠肽水平与肺栓塞的发生呈正相关性,是评估患者病情的重要指标,具有十分重要临床指导价值.
목적 탐토D-Dimer、C-반응단백화뇌납태재폐전새환자적림상진단개치이급령민도、특이도화준학도대비연구.방법 수궤선취2013년5월~2014년5월간수치적대면적폐전새환자45례,소면적폐전새환자45례,병선취동기체검적건강자45례작위대조조.검측병비교치료전후각조혈장D-Dimer、CRP화BNP수평.채용Logistic분석환자혈장D-Dimer、CRP화BNP수평여폐전새발생적상관성.이폐전새검험금표준(폐동맥조영)분별여D-dimer검험、CRP검험화BNP검험법주배대잡방검험,계산D-dimer검험、CRP검험화BNP검험3충검측방법적령민도、특이도화준학도,병비교기차이.결과 치료전,대면적조화소면적조폐전새D-Dimer、CRP화BNP수평균현저고우대조조(P<0.05);대면적조D-Dimer、CRP화BNP수평야명현고우소면적조(P<0.05).치료후,대면적조화소면적환자혈장D-Dimer、CRP화BNP수평명현하강(P<0.05) ,차여정상대조조비교,차이무통계학의의.Logistic분석결과표명,혈장D-Dimer、CRP화BNP수평여폐전새적발생정정상관성(r=3.11,P<0.05; r=4.36,P<0.05; r=2.86, P<0.05).D-Dimer검측、CRP검측화BNP검측방법재검측령민도、특이도화준학도방면차이무통계학의의.결론 D-dimer、C-반응단백화뇌납태수평여폐전새적발생정정상관성,시평고환자병정적중요지표,구유십분중요림상지도개치.
Objective To investigate D-Dimer, C-reactive protein and brain natriuretic peptide in clinical diagnosis of patients with pulmonary embolism and to compare the sensitivity, specificity and accuracy.Methods 45 cases of large area pulmonary embolism and 45 cases of small areapulmonary embolism were selected, at the same time, 45 cases of normal people were selected as the control group.D-dimer, CRP and BNP levels were detected and compared of each group before and after treatment.The relevance between D-Dimer, CRP, BNP levels and pulmonary embolism was analyzed by Logistic analysis.The gold standard of pulmonary embolism with D-dimer test, CRP test and BNP test were compared.the sensitivity, specificity and accuracy ofD-dimer test, CRP test and BNP test wer calculated.Results D-Dimer, CRP and BNP levels of the large area group and small area group were significantly higher than those in the control group before treatment (P<0.05);the D-Dimer, CRP and BNP levels of large area group were significantly higher than those in small area group (P<0.05).After treatment, the D-Dimer, CRP and BNP levels of large area group and small area were significantly decreased (P<0.05), and had no significant difference compared with normal control group.Logistic analysis showed that there was significant positive correlation between plasma, D-Dimer, CRP and BNP levels and pulmonary embolism (r=3.11, P<0.05;r=4.36, P<0.05;r=2.86, P<0.05) .There was no significant difference of sensitivity, specificity and accuracy of three methods.Conclusion There is a positive correlation between the occurrence of pulmonary embolism and D-dimer, CRP, BNP levels, which are important indexs to evaluate the patient's condition, it has very important clinical value.