彩色多普勒超声联合血浆D-二聚体诊断下肢静脉血栓的临床价值被引量：39

Clinical value of color Doppler ultrasonography combined with plasma D-dimer in diagnosis of lower extremity deep venous thrombosis

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摘要目的探讨彩色多普勒超声联合血浆D-二聚体诊断下肢深静脉血栓(DVT)的临床价值。方法对300例疑为下肢手术后DVT患者行彩色多普勒超声检测,并测定其术后不同时期的血浆D-二聚体含量。以下肢静脉造影结果为金标准,计算并比较两种检查方法单独及二者联合诊断DVT的敏感性、特异性、阳性预测值、阴性预测值及诊断准确率。比较不同类型及不同时期DVT患者血浆D-二聚体含量。结果彩色多普勒超声诊断DVT的敏感性、特异性、阳性预测值、阴性预测值及诊断准确率分别为95.8%、99.6%、98.6%、99.0%、98.7%;血浆D-二聚体诊断DVT的敏感性、特异性、阳性预测值、阴性预测值及诊断准确率分别为97.2%、87.2%、70.7、98.7%、89.7%;二者联合诊断DVT的敏感性、特异性、阳性预测值、阴性预测值及诊断准确率分别为98.6%、100%、100%、99.6%、99.7%。混合型及中央型DVT患者的血浆D-二聚体含量高于周围型,差异均有统计学意义(均P<0.05);急性期及亚急性期DVT患者的D-二聚体含量均高于慢性期,差异均有统计学意义(均P<0.05)。结论彩色多普勒超声联合血浆D-二聚体诊断DVT的敏感性、特异性较高,具有较高的临床价值。 Objective To investigate the clinical value of the color Doppler ultrasonography combined with plasma Ddimer determination in the diagnosis of lower extremity deep venous thrombosis（DVT）.Methods The plasma D-dimer in 300 patients with suspected lower extremity DVT after operation was determined at different stages.And color Doppler ultrasonography was performedon.The results of the following limb venography were taken as a gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of each method alone or the combination of the two methods for the diagnosis of DVT were calculated and compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of color Doppler in diagnosis of DVT were 95.8%,99.6%,98.6%,99.0% and 98.7%,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of the individual plasma D-Dimer polymers were 97.2%,87.2%,70.7%,98.7% and 89.7%.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy were 98.6%,100%,99.6%,100%,and 99.7% with the combination of the two methods.The plasma D-dimer in patients with mixed type and central type DVT was higher than that of peripheral type（all P〈0.05）.The content of D-dimer in patients with acute and subacute DVT was higher than that in chronic phase（all P〈0.05）.Conclusion The application of color Doppler ultrasonography combined with plasma D-dimer determination has high sensitivity and specificity in the diagnosis of DVT,which has high clinical value.

作者郭志英栗平张淑珍

机构地区内蒙古医科大学第二附属医院功能科

出处《临床超声医学杂志》 2017年第2期132-134,共3页 Journal of Clinical Ultrasound in Medicine

关键词超声检查多普勒彩色 D-二聚体下肢静脉血栓 Ultrasonography Doppler color D-dimer Lower extremity deep venous thrombosis

分类号 R619.2 [医药卫生—外科学] R445.1 [医药卫生—影像医学与核医学]