随年龄调整的D-二聚体临界值标准在急性肺栓塞诊断中的价值

发布时间：2018-03-09 10:27

本文选题：肺栓塞　切入点：D-二聚体　出处：《浙江大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：探讨随年龄调整的D-二聚体临界值标准在急性肺栓塞诊断中的价值。方法：以螺旋CT肺动脉造影为诊断标准,检测1056例疑似肺栓塞患者D-二聚体浓度,分别计算传统标准组和随年龄调整的临界值标准组的敏感性、特异性、准确性、阴性预测值及阳性预测值。结果：按传统D-二聚体标准判断结果,阴性352例,阳性704例,其中真阳性156例,真阴性343例,按新的D-二聚体标准判断结果,阴性474例,阳性582例,其中真阳性156例,真阴性465例。两者的敏感性、特异性、准确性、阴性预测值及阳性预测值,前者依次为94.55%、38.50%、47.25%、97.44%、22.16%,后者依次为94.55%、52.19%、58.81%、98.10%、26.80%,两者在敏感性相同的情况下,后者的特异性和准确性均较前者明显升高,尤其是特异性增加了13.69%,两者的Youden指数有显著性差异(Z=4.58,P0.01)。结论：应用随年龄调整的D-二聚体临界值标准,提高了D-二聚体检测在老年急性肺栓塞诊断中的特异性,并且同时没有降低敏感性。
[Abstract]:Objective:. To investigate the value of age-adjusted threshold of D-dimer in the diagnosis of acute pulmonary embolism. The D-dimer concentration of 1056 suspected pulmonary embolism patients was detected by spiral CT pulmonary angiography, and the sensitivity, specificity and accuracy of the traditional standard group and the age-adjusted critical value standard group were calculated, respectively. Negative predictive value and positive predictive value. Results:. According to traditional D- dimer criteria, 352 cases were negative, 704 cases were positive, 156 cases were true positive, 343 cases were true negative, 474 cases were negative and 582 cases were positive according to the new standard, 156 cases were true positive. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of the two groups were 94.55, 38.50, 47.257.44 and 22.16, respectively, and the latter were 94.5552.191.58.81and 98.100.80, respectively. The specificity and accuracy of the latter were significantly higher than those of the former. In particular, the specificity was increased by 13.699.The Youden index of the two groups was significantly different from that of 4.58% (P 0.01). Conclusion:. The application of age-adjusted threshold of D-dimer improved the specificity of D-dimer in the diagnosis of acute pulmonary embolism in the elderly, and did not decrease the sensitivity at the same time.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.5

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