摘要
目的探讨D-Dimer、C-反应蛋白和脑钠肽在肺栓塞患者的临床诊断价值以及灵敏度、特异度和准确度对比研究。方法随机选取2013年5月~2014年5月间收治的大面积肺栓塞患者45例,小面积肺栓塞患者45例,并选取同期体检的健康者45例作为对照组。检测并比较治疗前后各组血浆D-Dimer、CRP和BNP水平。采用Logistic分析患者血浆D-Dimer、CRP和BNP水平与肺栓塞发生的相关性。以肺栓塞检验金标准(肺动脉造影)分别与D-dimer检验、CRP检验和BNP检验法做配对卡方检验,计算Ddimer检验、CRP检验和BNP检验3种检测方法的灵敏度、特异度和准确度,并比较其差异。结果治疗前,大面积组和小面积组肺栓塞D-Dimer、CRP和BNP水平均显著高于对照组(P<0.05);大面积组D-Dimer、CRP和BNP水平也明显高于小面积组(P<0.05)。治疗后,大面积组和小面积患者血浆D-Dimer、CRP和BNP水平明显下降(P<0.05),且与正常对照组比较,差异无统计学意义。Logistic分析结果表明,血浆D-Dimer、CRP和BNP水平与肺栓塞的发生呈正相关性(r=3.11,P<0.05;r=4.36,P<0.05;r=2.86,P<0.05)。D-Dimer检测、CRP检测和BNP检测方法在检测灵敏度、特异度和准确度方面差异无统计学意义。结论 D-dimer、C-反应蛋白和脑钠肽水平与肺栓塞的发生呈正相关性,是评估患者病情的重要指标,具有十分重要临床指导价值。
Objective To investigate D-Dimer, C-reactive protein and brain natriuretic peptide in clinical diagnosis of patients with pulmonary embolism and to compare the sensitivity, specificity and accuracy.Methods 45 cases of large area pulmonary embolism and 45 cases of small areapulmonary embolism were selected, at the same time, 45 cases of normal people were selected as the control group.D-dimer, CRP and BNP levels were detected and compared of each group before and after treatment.The relevance between D-Dimer, CRP, BNP levels and pulmonary embolism was analyzed by Logistic analysis.The gold standard of pulmonary embolism with D-dimer test, CRP test and BNP test were compared.the sensitivity, specificity and accuracy ofD-dimer test, CRP test and BNP test wer calculated.Results D-Dimer, CRP and BNP levels of the large area group and small area group were significantly higher than those in the control group before treatment (P<0.05);the D-Dimer, CRP and BNP levels of large area group were significantly higher than those in small area group (P<0.05).After treatment, the D-Dimer, CRP and BNP levels of large area group and small area were significantly decreased (P<0.05), and had no significant difference compared with normal control group.Logistic analysis showed that there was significant positive correlation between plasma, D-Dimer, CRP and BNP levels and pulmonary embolism (r=3.11, P<0.05;r=4.36, P<0.05;r=2.86, P<0.05) .There was no significant difference of sensitivity, specificity and accuracy of three methods.Conclusion There is a positive correlation between the occurrence of pulmonary embolism and D-dimer, CRP, BNP levels, which are important indexs to evaluate the patient''s condition, it has very important clinical value.
出处
《中国生化药物杂志》
CAS
2015年第10期76-78,共3页
Chinese Journal of Biochemical Pharmaceutics
基金
唐山市科技支撑计划项目(13130212a)
关键词
D-DIMER
C反应蛋白
脑钠肽
肺栓塞
灵敏度
特异度
准确度
D-Dimer
C-reactive protein
brain natriuretic peptide
pulmonary embolism
sensitivity
specificity
accuracy
