SpO_2联合cTnT、心电图在D二聚体阴性肺栓塞患者筛查中的效果评价

目的观察血氧饱和度（SpO2）、肌钙蛋白T（cTnT）、心电图在D二聚体（D-D）阴性肺栓塞（PTE）患者早期筛查中的作用。方法收集我院2010-01-2014-01间诊治的66例急性PTE患者,其中初诊D-D阴性8例,同时选取同期65例健康体检人群作为对照组,测定两组患者SpO2、血浆cTnT、D-D水平及观察两组的心电图变化,了解PTE与无PTE患者的SpO2、血浆cTnT、D-D及心电图的差异。结果栓塞组的SpO2明显低于对照组（P〈0.05）。栓塞组cTnT值≥0.04 ng/mL的比率均明显高于对照组（P〈0.01）。栓塞组D-D的比率明显高于对照组（P〈0.05）,栓塞组的心电图异常率明显高于对照组,D-D阴性肺栓塞患者的SpO2、血浆cTnT及心电图明显异常。结论对于临床高度可疑肺栓塞的患者,不能仅仅依靠D-二聚体去筛选,应综合危险因素、联合应用SpO2、cTnT、D-D水平及心电图等多项指标进行筛选,避免此类患者的漏诊及误诊。

Evaluation of SpO2 Combined with Cadiac Troponin T and ECG in Patients with Negative D-dimer Pulmonary Embolism

Objective To observe the role of SpO2, troponin T （cTnT）, electrocardiogram（ECG） in patients with negative D -dimer pulmonary embolism （PTE）. Methods Selecting 66 PTE patients in the hospital from January, 2010 to January, 2014, among which 8 cases were diagnosed as negative D - dimer, and selecting 65 healthy cases as the control group. The differences of SpO2, plasma cTnT, D - dimer levels and ECG were observed. Results SpO2, pulmonary embolism group was significantly lower than the control group （P 〈0.05）. The rate of cTnT t〉0.04 ng/mL in the embolism group was significantly higher than the control group（P 〈0.01 ）. Conclusion Patients with clinical highly suspected pulmonary embolism cannot just rely on D - dimer to screening. Comprehensive risk factors of PTE patients, blood oxygen saturation, cTnT, D - dimer level and ECG should be used to select screening index, in order to avoid missed diagnosis and misdiagnosis in patients with pulmonary embolism.