论文部分内容阅读
目的探讨多排螺旋CT肺血管成像(MSCTPA)结合血浆D-二聚体(D-dimer,DD)测定在肺动脉栓塞(pulmonaryem-bolism,PE)诊断中的应用价值方法对48例临床可疑PE患者进行MSCTPA检查和血浆DD检测以临床诊断为依据,分别评价MSCTPA、DD测定及MSCTPA结合血浆DD测定对PE的诊断价值其中22例病人于MSCTPA检查结果阳性后即进行溶栓治疗,并于治疗后第2天、第3天、第7天及2周分别复查DD值,于治疗后2周内分别复查了1次MSCTPA结果DD测定值全部阳性(48例),阳性率100%;MSCTPA共检出PE45例,3例无明显栓塞征象(2例肺内见片状炎性浸润影,1例两肺见散在纤维束条影),45例PE中1例MSCTPA首诊结果可疑,在DD阳性的提示下行0.625mm薄层重建肯定了PE的诊断溶栓治疗后复查的22例中,13例于1周内DD测定值升高,1周后DD测定值下降,9例DD值变化不明显;MSCTPA复查中DD值先升高后下降的13例充盈缺损征象明显改善,9例DD值变化不明显者充盈缺损征象亦无明显变化结论MSCTPA和血浆DD测定结合可提高PE的检出率,对诊断PE具有重要的临床应用价值
Objective To investigate the value of multislice CT pulmonary angiography (MSCTPA) combined with plasma D-dimer (D-dimer, DD) in the diagnosis of pulmonary arterial embolism (PE). Methods Forty-eight patients with clinically suspected PE The diagnostic value of MSCTPA, DD and MSCTPA combined with plasma DD in PE was evaluated based on clinical diagnosis. MSCTPA and plasma DD were used to evaluate the diagnostic value of PE. Twenty-two patients were treated with thrombolytic therapy after positive MSCTPA and after treatment The DD values were examined on the second day, the third day, the seventh day and the second week respectively. The results of DDT were all confirmed by MSCTPA in 48 weeks after the treatment. The positive rate was 100% PE 45 cases, 3 cases no obvious signs of embolism (2 cases of lung see flaky inflammatory infiltration shadow, one case of two lung see loose fibers in the strip), 45 cases of PE in 1 cases of MSCTPA first diagnosis of suspicious results, DD positive Of the tips down 0.625mm thin layer reconstruction affirmed the diagnosis of PE diagnosis of thrombolytic therapy review of 22 cases, 13 cases within 1 week DD measured value increased after 1 week, DD measured decreased, 9 cases of DD did not change significantly ; In the MSCTPA review, the DD value increased first and then decreased, the signs of filling defects in 13 cases were improved obviously. The DD value in 9 cases did not change obviously No significant change in signs of filling defects conclusions MSCTPA DD and plasma binding assay can increase the detection rate of PE, it has important clinical value in the diagnosis of PE