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目的探讨血浆D-二聚体测定用于临床快速排除肺栓塞的意义。方法选择2007年1月-2008年12月为确诊是否患有肺栓塞而接受CTPA检查者358例,记录并分析CTPA检查和血浆D-二聚体检测结果。结果试验组和非试验组患者CTPA阳性率间差异无统计学意义(P>0.05);血浆D-二聚体检测的敏感性为100%(95%CI:92.7～100.0),特异性为24.6%(95%CI:19.7～29.4),阳性似然比和阴性似然比分别为4.07和0。结论血浆D-二聚体检测是一种非常有价值的检测,可应用于疑似肺栓塞患者在接受CTPA前进行筛选,同时也非常具有经济价值,可降低患者的医疗成本。
Objective To investigate the significance of plasma D-dimer in the clinical diagnosis of pulmonary embolism. Methods From January 2007 to December 2008, 358 patients undergoing CTPA for diagnosis of pulmonary embolism were selected, and the results of CTPA and D-dimer were recorded and analyzed. Results There was no significant difference in CTPA positive rate between test group and non-test group (P> 0.05). The sensitivity of plasma D-dimer test was 100% (95% CI: 92.7-100.0) and the specificity was 24.6 % (95% CI: 19.7-29.4). The positive likelihood ratio and negative likelihood ratio were 4.07 and 0 respectively. Conclusions Plasma D-dimer testing is a valuable test that can be applied to patients with suspected pulmonary embolism prior to screening for CTPA and is also very cost-effective to reduce the patient’s medical costs.