Wells评分联合D-二聚体检测对急性肺栓塞的诊断价值  

Diagnostic value of Wells score and D-Dimer detection in acute pulmonary embolism

作　　者：汤翠英[1] 赵文翰[1] 庾慧[1] 

机构地区：[1]广东省中医院,广州市510370

出　　处：《实用医学杂志》2016年第15期2480-2482,共3页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2014KT1510)

摘　　要：目的:评价Wells评分联合D-二聚体(D-Dimer)检测在急性肺栓塞(APE)诊断中的作用。方法:收集我院2012年3月至2014年9月疑诊APE患者共42例进行前瞻性调查,以Wells评分表结合DDimer检测对患者进行评估,以预测其发生肺栓塞的临床可能性。结果 :42例疑诊患者中,共有26例经肺动脉造影(CTPA)确诊。采用Wells评分临床评估为低度、中度、高度疑似肺栓塞者分别为7、24、11例,其中经CTPA确诊为肺栓塞者分别为1、15、10例,确诊率分别为14.2%(1/7)、62.5%(15/24)、90.9%(10/11)。肺栓塞组D-Dimer水平明显高于非肺栓塞组(P<0.01)。肺栓塞组Wells评分中度可能性及高度可能性组D-Dimer水平明显高于Wells评分低度可能性组(P<0.05)。结论:Wells评分联合D-Dimer检测对急性肺栓塞临床可能性预测方面,具有方便、准确、安全、无创等优点,值得临床推广应用。Objective To assess the diagnostic value of Wells score and D-Dimer detection in acute pulmonary embolism. Methods Forty-two suspected cases of pulmonary embolism were collected from March2012 to September 2014 Then Wells score and D-Dimer detection were applied to confirm the disease. Results Of the total, 26 patients were diagnosed by computed tomographic pulmonary arteriography（CTPA）. There were7, 24 and 11 suspected cases which had low, medium and high Wells score respectively. Among them, 1, 15,and 10 cases were diagnosed by CTPA. The diagnosis rates were 14.2%（1 / 7）, 62.5%（15 / 24） and 90.9%（10 / 11） respectively. The D-Dimer level in pulmonary embolism group was significantly higher than that in nonembolism group（P〈0.01）. The D-Dimer level of cases with medium or high Wells score was higher than those with low Wells score（P〈0.05）. Conclusion Wells score combined with D-Dimer is convenient, accurate and safe for predicting acute pulmonary embolism.

关 键 词：肺栓塞 WELLS评分 D-二聚体 诊断 

分 类 号：R563.5[医药卫生—呼吸系统]