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目的:探讨D-二聚体在致命性胸痛病因诊断中的应用价值。方法:选取我院急诊科接诊的82例急性胸痛患者作为研究对象,所有患者入院后均进行心电图、CK-MB(肌酸激酶同功酶)、肌钙蛋白T、D-二聚体检查,回顾性分析检查结果。结果:82例患者最终确诊为不稳定心绞痛18例、急性心肌梗死45例、肺栓塞6例、肺炎3例、主动脉夹层10例。D-二聚体对肺栓塞的阴性预测值最高,为100.0%,同时对急性心肌梗死、不稳定心绞痛、主动脉夹层、肺炎的阴性预测值也较高,分别为66.67%、77.78%、80.00%、66.67%。结论:对致命性胸痛患者进行D-二聚体检测,可快速筛选出疑似肺栓塞患者,其在胸痛病因诊断中具有重要价值。
Objective: To investigate the value of D-dimer in the etiological diagnosis of fatal chest pain. Methods: A total of 82 patients with acute chest pain admitted to the emergency department of our hospital were enrolled in this study. All patients underwent ECG, CK-MB (creatine kinase isoenzyme), troponin T, D-dimer , Retrospective analysis of test results. Results: 82 patients were diagnosed as unstable angina in 18 cases, 45 cases of acute myocardial infarction, 6 cases of pulmonary embolism, 3 cases of pneumonia and 10 cases of aortic dissection. The negative predictive value of D-dimer for pulmonary embolism was the highest (100.0%), while the negative predictive value for acute myocardial infarction, unstable angina, aortic dissection and pneumonia were also higher, which were 66.67%, 77.78% and 80.00 %, 66.67%. Conclusion: D-dimer test for patients with fatal chest pain can rapidly screen patients suspected of pulmonary embolism, which is of great value in the diagnosis of chest pain.