年龄校正的D-二聚体联合Daniel心电图评分在急性肺栓塞中的诊断价值  

The diagnostic value of age-adjusted D-dimer combined with Daniel electrocardiogram score in acute pulmonary embolism

作　　者：方年新[1] 张平[1] 叶观生 刘镇威 卢伟波 吴森泉 FANG Nian-xin;ZHANG Ping;YE Guan-sheng(Department of Pulmonary and Critical Care Medicine,Dongguan People’s Hospital,Dongguan 523000,China)

机构地区：[1]东莞市人民医院呼吸与危重症医学科

出　　处：《中国现代药物应用》2020年第4期17-19,共3页Chinese Journal of Modern Drug Application

基　　金：广东省东莞市社会科技发展(一般)项目(立项编号：201750715001296)

摘　　要：目的探讨年龄校正的D-二聚体联合Daniel心电图评分在急性肺栓塞(APE)中的诊断价值。方法158例年龄校正的D-二聚体阳性疑似急性肺栓塞患者,根据肺动脉CT血管造影(CTA)检查结果分为急性肺栓塞组(急性肺栓塞患者)和对照组(无急性肺栓塞患者),每组79例。两组均进行Daniel心电图评分。比较两组Daniel心电图评分,并应用ROC曲线评估其对急性肺栓塞的诊断价值。结果急性肺栓塞组的Daniel心电图评分(3.97±2.19)分显著高于对照组的(1.52±1.42)分,差异具有统计学意义(P<0.05)。ROC曲线下面积为0.832(标准误为0.033),面积95%CI=(0.767,0.897),Daniel心电图评分越大诊断肺栓塞的可能性越大,最佳界值为2分,在该处敏感性和特异度为最大,以≥2分诊断肺栓塞的敏感性为82.28%,特异度为75.95%。结论年龄校正的D-二聚体联合Daniel心电图评分在急性肺栓塞中具有较好的诊断价值。Objective To discuss the diagnostic value of age-adjusted D-dimer combined with Daniel electrocardiogram score in acute pulmonary embolism(APE).Methods A total of 158 cases of suspected acute pulmonary embolism with age-adjusted positive D-dimer were divided into acute pulmonary embolism group(patients with acute pulmonary embolism)and control group(patients without acute pulmonary embolism)by CT angiography CTA of pulmonary artery,with 79 cases in each group.Daniel electrocardiogram scores were performed in both groups.Daniel electrocardiogram score was compared between the two groups,and ROC curve was used to evaluate its diagnostic value for acute pulmonary embolism.Results Daniel electrocardiogram scores(3.97±2.19)points in acute pulmonary embolism group was significantly higher than(1.52±1.42)points in the control group,and the difference was statistically significant(P<0.05).The area under the ROC curve was 0.832(standard error was 0.033),and the area was 95%CI=(0.767,0.897).The larger the Daniel electrocardiogram score,the more likely it is to diagnose pulmonary embolism.The optimal cutoff was 2 points,which was sensitive at this point.The degree and specificity were the highest,and the sensitivity for diagnosis of pulmonary embolism with≥2 points was 82.28%,and the specificity was 75.95%.Conclusion Age adjusted D-dimer combined with Daniel electrocardiogram score has a better diagnostic value in acute pulmonary embolism.

关 键 词：年龄校正的D-二聚体 Daniel心电图评分 急性肺栓塞 

分 类 号：R563.5[医药卫生—呼吸系统]