摘要
目的:探讨临床量表在老年非高危急性肺栓塞诊断中的预测价值。方法:根据2008年欧洲新版急性肺栓塞诊疗流程指南,连续收集在急诊诊治的268例可疑老年非高危肺栓塞患者的临床资料,分别进行Wells量表、Geneva量表和修正Geneva量表评估,并与最终确诊结果进行比较。结果:268例可疑老年非高危肺栓塞患者中,确诊为非高危肺栓塞78例;Wells量表、Geneva量表和修正Geneva量表高可能性组的阳性预测值分别为48.57%(34/70)、45.21%(33/73)和46.05%(35/76),低可能性组的阴性预测值分别为87.96%(95/108)、86.41%(89/103)和90.91%(100/110)。诊断肺栓塞的阳性似然比、阴性似然比、Youden指数和一致性系数Wells量表分别为2.30、0.70、0.24和0.254,Geneva量表分别为2.01、0.73、0.21和0.217,修正Geneva量表分别为2.08、0.703、0.23和0.235。3种量表对肺栓塞诊断的敏感度、特异度比较差异无统计学意义。结论:3种临床量表在非高危急性肺栓塞筛查中具有一定的预测价值,且预测效率差异无统计学意义。
Objective：To evaluate diagnostic value of three clinical scores in elderly patients with acute non-high- risk pulmonary embolism （ PE ）. Methods： Wells, Geneva and Revised- Geneva scores were performed in 268 elderly patients suspected non- high- risk PE admitted to emergency, according to the latest guidelines of the European Society of Cardiology （ESC）. Results：Seventy-eight patients with non-high-risk PE were diagnosed with lung imaging as gold standard. Respectively, positive predictive values for high clinical probability of Wells score, Geneva score and Revised- Geneva score were 48.57% （ 34/70 ）, 45.21% （ 33/73 ） and 46. 05% （ 35/76 ） negative predictive values for low clinical probability of Wells score, Geneva score and Revised-Geneva score were 87.96% （95/108）, 86.41% （89/103） and 90.91% （100/110）. Positive and negative likelihood ratios, Youden index and crude agreement of Wells scorle were 2. 30, 0. 73, 0. 21 and 0. 217; and Revised-Geneva score were to three scores, the sensitivity and specificity in diagnosis 0. 70, 0. 24 and 0. 254 ; and Geneva score were 2. 01, 2. 08, 0. 703, 0. 23and 0. 235 ; respectively. Compared for PE was no statistical significance. Conclusions： In the screening of non high risk acute pulmonary embolism, clinical scores have some predictive value. The comparison of prediction efficiericy of three clinical scores don＇t have a significant statistically difference.
出处
《现代医学》
2014年第12期1383-1386,共4页
Modern Medical Journal
基金
江苏省卫生厅"科教兴卫"重点实验室开放课题(KF 200949)
关键词
急性肺栓塞
非高危
临床量表
老年
pulmonary embolism
non- high- risk
clinical scores
elderly
