| 孙承功,金 燕,朱 频,徐颖杰,王 栋.根据年龄校正的D-二聚体临界值标准对急性肺栓塞的诊断价值[J].,2017,17(20):3868-3870 |
| 根据年龄校正的D-二聚体临界值标准对急性肺栓塞的诊断价值 |
| The Diagnostic Value of Age-adjusted D-dimer Cut-off for the Acute Pulmonary Embolism |
| 投稿时间：2016-12-16 修订日期：2017-01-14 |
| DOI：10.13241/j.cnki.pmb.2017.20.015 |
| 中文关键词: 急性肺栓塞 年龄校正 D-二聚体 诊断 |
| 英文关键词: Acute Pulmonary Age-adjusted D-dimer Embolism Diagnosis |
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| 中文摘要: |
| 摘要 目的：探讨根据年龄校正的D-二聚体临界值标准对急性肺栓塞的诊断价值。方法：采用CT肺血管造影(CTPA)对367例疑似APE患者进行诊断，并采用酶联免疫吸附法(ELISA)检测患者的D-二聚体浓度，比较传统临界值标准(500 μg/L)和根据年龄校正的临界值标准[(年龄×10)μg/L]对诊断APE的敏感度、特异性、符合率、阳性预测值和阴性预测值。结果：367例疑似APE患者中，共确诊64例，检出率为17.4%。APE患者的D-二聚体浓度为(2108.5±335.9)μg/L，显著高于非APE患者D-二聚体浓度(486.8±65.2)μg/L(t=27.61，P<0.05)；年龄≥60岁的APE患者D-二聚体浓度为(2931.8±509.4)μg/L，显著高于年龄<60岁的APE患者D-二聚体浓度(1806.1±319.6)?滋g/L(t=10.77，P<0.05)。根据年龄校正的D-二聚体临界值诊断APE的特异度、符合率、阳性预测值及曲线下面积（AUC）较传统D-二聚体临界值显著升高(P<0.05)；两种临界值的灵敏度、阴性预测值比较差异无统计学意义(P>0.05)。结论：D-二聚体的浓度随年龄增加而增高，根据年龄校正的D-二聚体临界值标准可提高其对APE的诊断效率，减少漏诊，尤其适用于50岁以上人群。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the diagnostic value of age-adjusted d-dimer cut-off for the acute pulmonary embolism(APE). Methods: Computed Tomography Pulmonary Angiography(CTPA) was performed for the diagnosis of 367 cases of suspected APE, and enzyme-linked immunosorbent assay (ELISA) was used to detect D-dimer concentration. The sensitivity, specificity, accuracy, negative prediction value and positive predictive value between age-adjusted D-dimer cut-off [(age×10) μg/L] and traditional cut-off (500μg/L) was compared. Results: 367 suspected APE patients, 64 cases was confirmed with the detection rate of 17.4%.The concentration of D-dimer in APE patients was (2108.5±335.9) μg/L, was significantly higher than(486.8±65.2) μg/L in non APE patients (t=27.61,P<0.05). The concentration of D-dimer in APE patients more than 60 year-old was (2931.8±509.4) μg/L, was significantly higher than (1806.1±319.6) μg/L in patients less than 60 year-old (t=10.77, P<0.05). The specificity, coincidence rate, positive predictive value and area under the curve (AUC) of age-adjusted D-dimer cut-off in the diagnosis of APE were significantly increased than those of traditional D-dimer cut-off (P<0.05). While there was no significant difference on sensitivity, negative predictive value between two cut-offs(P>0.05). Conclusion: The D-dimer concentration was increased with the increase of age, age-adjusted D-dimer cut-off could improve the efficiency of the diagnosis of APE, reduce the missed diagnosis, it was especially suitable for the patients more than 50 years old. |
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