摘要
目的探究二维灰阶超声(2D-B/W)、彩色多普勒超声血流显像(CDFI)联合血浆纤维蛋白原(Fib)、D-二聚体(D-D)检测对下肢深静脉血栓(DVT)的诊断价值。方法选择2019年7月至2021年3月安徽医科大学附属安庆第一人民医院收治的90例下肢肿胀疼痛患者作为研究对象,其中DVT患者41例。所有患者均实施2D-B/W、CDFI检查,并测定血浆D-D、纤维蛋白原(Fib)水平。绘制各检查方法诊断DVT的受试者工作特征曲线,计算各自的曲线下面积(AUC),比较2D-B/W、CDFI、血浆Fib、血浆D-D单独及联合诊断DVT的诊断效能。结果DVT患者的血浆Fib、D-D水平均明显高于非DVT患者(P<0.05)。四项检查联合诊断DVT的AUC为0.938(95%CI:0.888~0.989),明显高于2D-B/W[0.739(95%CI:0.631~0.847)]、CDFI[0.891(95%CI:0.823~0.959)]、血浆Fib[0.758(95%CI:0.653~0.864)]、血浆D-D[0.826(95%CI:0.742~0.909)]单独诊断(P<0.05)。四项检查联合诊断DVT的敏感度、特异度和准确度分别为97.56%、93.88%和95.56%。结论2D-B/W、CDFI联合血浆Fib、D-D检测能够显著提高早期诊断DVT的诊断准确度,降低漏诊和误诊风险。
Objective To explore the diagnostic value of two dimensional black-and-white ultrasound(2D-B/W),color doppler flow imaging(CDFI)combined with plasma fibrinogen(Fib)and D-Dimer(D-D)detection in deep venous thrombosis(DVT)of lower limbs.Methods A total of 90 patients with lower limb swelling and pain admitted to Anqing First People’s Hospital of Anhui Medical University from July 2019 to March 2021 were selected as the research subjects,among them,41 patients with DVT.All patients underwent 2D-B/W and CDFI examinations,and plasma D-D and fibrinogen(Fib)levels were determined.The receiver operator characteristic curves for DVT were drawn and the area under the curve(AUC)was calculated.The diagnostic efficacy of 2D-B/W,CDFI,plasma Fib,and plasma D-D for DVT alone and in combination was compared.Results The levels of Fib and D-D in DVT patients were significantly higher than those in non-DVT patients(P<0.05).The AUC of the combination of four tests for DVT was 0.938(95%CI:0.888-0.989),which was significantly higher than that of 2D-B/W(0.739[95%CI:0.631-0.847]),CDFI(0.891[95%CI:0.823-0.959]),plasma Fib(0.758[95%CI:0.653-0.864]),and plasma D-D(0.826[95%CI:0.742-0.909])were diagnosed separately(P<0.05).The sensitivity,specificity and accuracy of the four tests were 97.56%,93.88% and 95.56%,respectively.Conclusion 2D-B/W,CDFI combined with plasma Fib and D-D detection can significantly improve the diagnostic accuracy of early diagnosis of DVT,and reduce the risk of missed diagnosis and misdiagnosis.
作者
郝君霞
胡金花
夏群
余奕
HAO Junxia;HU Jinhua;XIA Qun;YU Yi(Department of Ultrasound,Anqing First People’s Hospital of Anhui Medical University,Anhui Province,Anqing 246003,China)
出处
《中国医药导报》
CAS
2022年第7期104-107,共4页
China Medical Herald
