年龄校正D-二聚体在肺栓塞诊断的价值
投稿时间:2016-01-25  修订日期:2016-01-26  点此下载全文
引用本文:王升玲,孔英君.年龄校正D-二聚体在肺栓塞诊断的价值[J].医学研究杂志,2016,45(8):150-152
DOI: 10.11969/j.issn.1673-548X.2016.08.039
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作者单位E-mail
王升玲 150001 哈尔滨医科大学附属第一医院  
孔英君 150001 哈尔滨医科大学附属第一医院 kjtoday@sina.com 
中文摘要:目的 研究随年龄校正的D-二聚体临界值在肺栓塞的诊断价值。方法 螺旋CT肺动脉造影作为诊断急性肺栓塞的金标准,采用酶联免疫吸附法检测疑似肺栓塞患者血浆D-二聚体浓度,分别计算随年龄校正的D-二聚体临界值组和传统临界值组的敏感度、特异性、准确性、阴性预测值和阳性预测值。结果 传统D-二聚体临界值组敏感度为93.75%,漏诊率为6.25%,特异性为50.36%,误诊率为49.64%,准确性为57.31%,阳性预测值26.50%,阴性预测值97.68%,Youden指数为0.44,年龄校正组相对应的分别是93.75%、6.25%、60.14%、39.86%、78.04%、30.99%、98.05%、0.54。结论 两组临界值的敏感度相同,但是年龄校正D-二聚体临界值的特异性、阴性预测值和准确性明显增加,两者之间Youden指数差异有统计学意义(P<0.01)。
中文关键词:肺栓塞  D-二聚体  年龄校正
 
Diagnostic Value of Age-adjusted D-dimer in Pulmonary Thromboembolism
Abstract:Objective To study the diagnostic value of age-adjusted D-dimer combined with clinical probability in patients with pulmonary embolism. Methods Spiral CT pulmonary angiography for the diagnosis of acute pulmonary embolism is regarded as gold standard. The quantitative enzyme-linked immunosorbent assay (ELISA) was used to detect plasma D-dimer concentration in the suspected pulmonary embolism patients. Then we calculated separately sensitivity, specificity, accuracy, negative prediction value and positive predictive value of age-adjusted D-dimer cut-off groupand traditional cut-off group. Results The group of raditional D-dimer critical sensitivity was 93.75%, misdiagnosis rate was 6.25%, specificity of 50.36%.The rate of misdiagnosis was 49.64%, the accuracy was 57.31%, the positive predictive value was 26.5%, the negative predictive value was 97.68% and Youden index was 0.44. For another group, and the corresponding respectively was 93.75%,6.25%, 60.14%,39.86%,78.04%,30.99%, 98.5% and 0.54, respectively. Conclusion The sensitivity of the two groups was the same. But the specificity, negative predictive value and the accuracy of the age-adjusted D-dimer were significantly increased, and there were significant differences between the two groups, with P<0.01.
keywords:Pulmonary embolism  D-dimer  Age-adjusted
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