年龄校正D-二聚体对老年人急性肺栓塞的诊断价值  

The Diagnosing Value of Age-adjusted D-dimer in Acute Pulmonary Thromboembolism in Elderly Patients

作　　者：黄潘文[1] 方年新[1] 莫伟良 

机构地区：[1]广东省东莞市人民医院呼吸内科,523000

出　　处：《岭南急诊医学杂志》2015年第3期191-192,195,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨年龄校正的D-二聚体(D-dimer)结合临床风险评估在老年人急性肺栓塞(PTE)的诊断中的临床应用价值。方法:对疑患PTE的老年患者(≥60岁)进行修正的Geneva评分,根据评分结果分为低风险组及高风险组;D-二聚体分别使用传统临界值(500 ug/L)及年龄校正临界值[(年龄×10)ug/L]对诊断PTE的特异性及敏感性进行比较。结果:在356例患者中,191例为低风险组,165例为高风险组。在诊断PTE的特异性上,D-二聚体年龄校正临界值显著优于传统临界值(低风险组:41.0%vs 23.4%,高风险组:76.3%vs 55.9%,P<0.05),而在诊断PTE的敏感性上,两组无明显差异(P>0.05)。结论:年龄校正的D-二聚体临界值结合修正的Geneva评分可提高老年患者诊断PTE的特异性。Objective ：To explore the value of age-adjusted D-dimer combined with clinical probability to confirm or exclude acute pulmonary thromboembolism（PTE） in elderly patients..Method ：.Elderly patients（≥60 years）suspected with PTE were evaluated by the revised Geneva score,which divide into low-risk group and high-risk group.Conventional cut-off value was 500 ug / L,while age-adjusted cut-off value was set as patient＇s age ×10 ug / L..The sensitivity and specificity using the 2 cut-off values in confirming or excluding the diagnoses of PTE were compared.Results：The study consisted of 356 cases,using the revised Geneva score model,191 cases were scored as low-risk group,and 165 cases as high-risk group.The age-adjusted cut-off value of D-dimer was significantly better than conventional cut-off value in diagnosing specificity of PTE（low-risk group ： 41.0% vs 23.4%,high-risk group ：76.3%vs 55.9%,P〈0.05）and they were no significant difference in diagnosing sensitivity of PTE（P〈0.05）. Conclusion ：The age-adjusted D-dimer cut-off value combined with the revised Geneva score may increase diagnosing specificity of PTE in elderly patients.

关 键 词：肺栓塞 年龄校正D-二聚体 诊断 临床价值 

分 类 号：R563.5[医药卫生—呼吸系统]