简化日内瓦评分联合年龄调整d -二聚体对肺血栓栓塞的诊断预测价值

Hua Yuan, Fangfang Fan, Qing Dong, Wei Zhang, Bowen Ran, Xiaoyun Hu
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摘要

目的探讨简化日内瓦评分(SGS)、年龄调整d -二聚体(AADD)及其联合应用对肺血栓栓塞症(PTE)的诊断预测价值。方法选取2016年12月至2017年12月山西医科大学第一附属医院住院的102例疑似PTE患者为研究对象。所有入选患者均行SGS检查,收集AADD,以ct和/或通气/灌注阳性结果作为诊断PTE的金标准,计算SGS、AADD及SGS联合AADD的敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比、Yoden指数,分析PTE的诊断价值。结果102例疑似PTE患者中,确诊PTE 31例(30.4%),排除PTE 71例(69.6%),SGS诊断PTE的敏感性为80.6%,特异性为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诊断PTE的敏感性为93.5%,特异性为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诊断PTE的敏感性为92.0%,特异性为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可显著提高PTE的诊断效果,其阴性预测值和阳性预测值均高于单用时。关键词:肺血栓栓塞;简化日内瓦分数;年龄调整肺动脉栓塞;预测
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic predictive value of simplified Geneva score combined with age-adjusted D-dimer for pulmonary thromboembolism
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. Key words: Pulmonary thromboembolism; Simplified Geneva score; Age-adjusted D-dimer; Forecasting
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