摘要
目的探讨Padua评分及D-二聚体对2型糖尿病内科住院患者急性肺栓塞的预测价值。方法回顾性分析2013年1月-2016年3月解放军第474医院临床疑诊急性肺栓塞(APE)的2型糖尿病内科住院患者151例,应用R O C曲线分析法比较Padua评分及D-二聚体对2型糖尿病内科住院患者急性肺栓塞的预测价值。结果 Padua评分诊断2型糖尿病内科住院患者APE的最佳分界值4分,≥4分时灵敏度66.25%,特异度84.51%,约登指数0.51,ROC曲线下面积为0.804(95%CI=0.735~0.874);D-二聚体最佳分界值0.5 mg/L,≥0.5 mg/L时灵敏度72.5%,特异度62.5%,约登指数0.35,D-D诊断2型糖尿病内科住院患者APE的ROC曲线下面积为:0.675(95%CI=0.597~0.747)。Padua评分联合D-D诊断2型糖尿病内科住院患者APE的灵敏度82.35%,特异度63.94%,约登指数0.525,ROC曲线下面积:0.812(95%CI=0.736~0.853)。结论 Padua评分对2型糖尿病内科住院患者APE的预测价值特异度高,但灵敏度差,不理想。而D-二聚体对2型糖尿病内科住院患者APE的预测价值灵敏度高,特异性差。两者联合可提高预测价值,有助于临床医师早期发现糖尿病APE高危人群。
Objective To investigate the predicative value of Padua score combined D-dimer for type 2 diabetes mellitus patients with acute pulmonary embolism（APE）admitted to internal medicine department. Methods 151 internal medicine inpatients undergoing type 2 diabetes mellitus combined with suspected VTE hospitalized in 474 th hospital of PLA from January 2013 to March 2016 were collected. The receiver operating characteristic curve（ROC）was used to evaluate the value of Padua score、D-dimmer testing and the Padua score combined D-dimmer in diagnosing type 2 diabetes mellitus patients with APE. Results At the cut-off point of 4,the sensitivity、specificity and the Youden Index of the Padua score was 66.25%、84.51%、0.51 separately. At the cut-off point of 0.5mg/L,the sensitivity、specificity and the Youden Index of D-dimmer testing was 72.5% 、62.5% 、0.35. The sensitivity、specificity and the Youden Index of the Padua score combined D-dimmer was 82.35%、63.94%、0.525. The area under the ROC curve（AUC）in the Padua score、D-dimmer testing and Padua score combined D-dimmer for APE was 0.804（95%CI=0.735~0.874）,0.675（95%CI=0.597~0.747）,0.812（95%CI=0.736~0.853）. The AUC in the Padua score combined D-dimmer was the highest and there was significant difference compared with the other two indexes（P0.001）. There was no statistically significant difference between the AUC in the Padua score and AUC in D-dimmer testing（P0.05）. Conclusion The combination of the Padua score and D-dimmer testing can be more effective for assessing the risk of APE among type 2 diabetes mellitus inpatients than the Padua score or D-dimmer testing. It is an effective clinical value to predict early diagnosis of type 2 diabetes mellitus with APE admitted to internal medicine department.
出处
《新疆医学》
2017年第8期820-822,共3页
Xinjiang Medical Journal
