摘要
目的:探讨简化Geneva评分(SGS)、年龄校正的D-二聚体(AADD)及二者联合对肺血栓栓塞症(PTE)的诊断预测价值。方法:研究对象为山西医科大学第一医院2016年12月至2017年12月疑似诊断为PTE住院患者102例。对所有纳入患者进行SGS评分并收集其AADD,以CT肺动脉造影和/或核素肺通气/血流灌注阳性结果作为确诊PTE的金标准,计算SGS、AADD及SGS联合AADD对PTE诊断的敏感度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比、约登指数,并分析三者对PTE的诊断预测价值。结果:102例疑诊PTE患者中确诊PTE者31例(30.4%),排除PTE者71例(69.6%)。SGS在诊断PTE中敏感度为80.6%,特异度为76.1%,阳性预测值为59.5%,阴性预测值为90.0%,阳性似然比为3.37,阴性似然比为0.25,约登指数为0.567;AADD在诊断PTE中敏感度为93.5%,特异度为63.4%,阳性预测值为52.7%,阴性预测值为95.7%,阳性似然比为2.55,阴性似然比为0.10,约登指数为0.569;SGS联合AADD在诊断PTE中敏感度为92.0%,特异度为90.4%,阳性预测值为82.1%,阴性预测值为95.9%,阳性似然比为9.58,阴性似然比为0.09,约登指数为0.824。结论:SGS联合AADD可明显提高PTE诊断效能,其阴性预测价值与阳性预测价值均高于单独使用时。
Objective To investigate the diagnostic predictive value of simplified Geneva score(SGS),age-adjusted D-dimer(AADD)and their combination for pulmonary thromboembolism(PTE).Methods The study subjects were 102 hospitalized patients with suspected PTE from December 2016 to December 2017 in the First Affiliated Hospital of Shanxi Medical University.SGS was performed in all included patients and AADD was collected,with computed tomography and/or ventilation/perfusion positive results as the gold standard for the diagnosis of PTE.The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,and Yoden index of SGS,AADD and SGS combined with AADD were calculated and the diagnostic value of PTE was analyzed.Results Of the 102 patients with suspected PTE,31 cases(30.4%)were diagnosed with PTE,and 71 cases(69.6%)were excluded from PTE.The sensitivity of SGS in diagnosing PTE was 80.6%,specificity was 76.1%,positive predictive value was 59.5%,negative predictive value was 90.0%,positive likelihood ratio was 3.37,negative likelihood ratio was 0.25,and Youden index was 0.567.The sensitivity of AADD in diagnosing PTE was 93.5%,specificity was 63.4%,positive predictive value was 52.7%,negative predictive value was 95.7%,positive likelihood ratio was 2.55,negative likelihood ratio was 0.10,and Youden index was 0.569.The sensitivity of SGS combined with AADD in diagnosing PTE was 92.0%,specificity was 90.4%,positive predictive value was 82.1%,negative predictive value was 95.9%,positive likelihood ratio was 9.58,negative likelihood ratio was 0.09,and Youden index was 0.824.Conclusions The combination of SGS and AADD can significantly improve the diagnostic efficacy of PTE,and its negative predictive value and positive predictive value are higher than when used alone.
作者
袁华军
樊芳芳
董清
张潍
冉博文
胡晓芸
Yuan Huajun;Fan Fangfang;Dong Qing;Zhang Wei;Ran Bowen;Hu Xiaoyun(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Science and Education,Shanxi Bethune Hospital,Taiyuan 030000,China)
出处
《国际呼吸杂志》
2020年第6期407-410,共4页
International Journal of Respiration
