摘要
目的探讨彩色多普勒超声联合D-二聚体(D-D)及CRP检测值对下肢深静脉血栓患者并发肺血栓预测价值。方法回顾性分析73例下肢深静脉血栓(DVT)合并肺栓塞(PE)患者(DVT+PE组)和91例单纯下肢深静脉血栓患者(DVT组)的超声血栓特征,结合血浆D-二聚体及CRP检测值进行统计分析,并应用ROC曲线检验三者联合诊断DVT合并PE的临床价值。结果两组患者的血栓性质(急性、慢性)之间差异具有统计学意义(χ2=20.461,P<0.001),两组D-二聚体检测值差异有统计学意义(t=25.814,P<0.05),两组CRP检测值差异有统计学意义(z=6.750,P=0.009)。性别、年龄、血栓位置、血栓范围差异无统计学意义(P>0.05)。ROC曲线分析分别以D-二聚体=1205.0ng/ml、CRP=83.55mg/L为诊断DVT合并PE最佳临界值时,敏感性分别为89.9%和60.0%,特异性分别为37.0%和75.3%,ROC曲线下面积(area under the ROC curve,AUC)分别为0.683和0.679。以D-二聚体=1085.5ng/ml、CRP=51.035mg/L作为血栓急性、慢性最佳临界值时,敏感性分别为78.0%和63.4%,特异性分别为60.5%和84.0%,AUC分别为0.738和0.801。结论联合运用彩色多普勒超声、D-二聚体及CRP检测可提高诊断DVT并发PE的敏感性,可作为肺栓塞高危患者的首选筛查方法。
Objective To evaluate the predictive value of color Doppler ultrasound combined with the measurements of D-dimer（D-D）and C-reactive protein（CRP）for patients with lower extremity deep vein thrombosis（DVT）complicated with pulmonary embolism（PE）. Methods A retrospective analysis of ultrasonic thrombus characteristics was performed for 73 cases of lower extremity DVT with PE（DVT ＋ PE group）and for 91 cases of lower extremity DVT only（DVT group）.Their property of thrombus checked by color Doppler ultrasound was statistically analyzed by combing with the measurements of the plasma D-D and CRP.The ROC（receiver operating characteristic curve）was used to assay the clinical value of the combination of color Doppler ultrasound and D-D,CRP detection in diagnosis of DVT associated with PE. Results There was statistically significant difference between acute and chronic of thrombus for both groups of patients（χ2=20.461,P〈0.001）.DVT ＋ PE group had higher D-D level than DVT group,comparison showed statistically significant difference（t=25.814,P〈0.05）.DVT ＋ PE group had higher CRP level than DVT group,comparison showed statistically significant difference（z=6.750,P =0.009）.However,there was no statistically significant difference in gender,age,thrombus locations and thrombus scales too（P〈0.05）.The ROC analysis was conducted when D-D=1205.0 ng/ml,CRP=83.55 mg/L were selected as the optimum cut-off values in diagnosis of DVT associated with PE.The sensitivity was 89.9%and 60.0%,and the specificity was 37.0%and75.3%,respectively.The area under the ROC curve（AUC）was 0.683 and 0.679,respectively.When D-D=1085.5 ng/ml,CRP =51.035 mg/L was selected as the optimum cut-off values to distinguish the acute thrombus from chronic thrombus,the sensitivity was 78.0%and 63.4%,and the specificity was 60.5%and 84.0%,respectively.Its AUC was 0.738 and 0.801,respectively. Conclusion A combination of color Doppler ultrasound,D-D and CRP detection can improve the diagnostic sensitivity of DV
出处
《右江民族医学院学报》
2017年第6期458-461,468,共5页
Journal of Youjiang Medical University for Nationalities
