D-二聚体测定联合临床评分对急性肺栓塞的诊断价值

目的评价D-二聚体测定联合临床评分对急性肺栓塞的诊断价值。方法以经过CT肺动脉造影确诊的急性肺栓塞（APE）患者为观察组（74例）,以排除APE的患者为对照组（74例）,两组患者均行D-二聚体测定及临床评分（改良Geneva评分）。结果观察组中,23例大面积APE患者经积极治疗后,21例痊愈,死亡2例,病死率为8.69%;51例非大面积APE的患者全部治愈,无一例死亡。74例APE患者的Geneva评分：0～3分4例（5.40%）;4～10分50例（67.57%）;≥11分20例（27.03%）。观察组的Geneva评分和血浆D-二聚体浓度均明显高于对照组（P〈0.01）。结论 D-二聚体测定联合改良Geneva评分对APE疑似患者的确诊有极大的临床意义,值得临床推广应用。

Value of D-dimer testing combined with clinical scoring in diagnosis of acute pulmonary embolism

Objective To evaluate the value of D-dimer testing combined with clinical scoring in the diagnosis of acute pulmonary embolism(APE).Methods Seventy four patients diagnosed as APE by CT arteriography of pulmonary arteries were chosen as observation group,and 74 ones without APE were chosen as control group.Both of the two groups received D-dimer testing and clinical scoring(modified Geneva scoring).Results In the observation group,after active treatment,21 ones among the 23 patients with large area of APE were cured,and 2 ones died with the case fatality rate of 8.69%.Fifty one patients with non-large area of APE were all cured,and no death occurred.The Geneva scores of 74 patients with APE were as follow:0-3 scores in 4 cases(5.40%),4-10 scores in 50 cases(67.57%)and more than or equal to 11 scores in 20 cases(27.03%).The Geneva scores and plasma D-dimer level of the observation group were significantly higher than those of the control group(P<0.01).Conclusion D-dimer testing combined with modified Geneva scoring has great clinical significance in the final diagnosis of patients suspected of APE.