血浆D二聚体联合PAI-1诊断COPD合并PTE的ROC曲线分析

Diagnostic significance of detection of plasma D-dimer and PAI-1 in COPD patients complicated with PTE by ROC curve

目的评价血浆组织纤溶酶原激活物抑制物-1(PAI-1)、D-二聚体(D-dimer,DD)检测在慢性阻塞性肺疾病(COPD)合并肺血栓栓塞症(PTE)诊断中的价值。方法分别对COPD合并PTE组和COPD组患者血浆PAI-1、DD含量进行比较,应用受试者工作曲线(ROC曲线)分析PAI-1、DD诊断COPD合并PTE时的敏感性、特异性、ROC曲线下面积同时计算其阳性率。结果COPD合并PTE组PAI-1、DD水平明显高于COPD组以98.5ng/L、1.85mg/L为阳性界点,PAI-1、DD两者联合诊断肺栓塞的敏感性为87.6%,特异性为85.6%,两者联合检测敏感、特异性明显高于PAI-1或DD单项(P<0.05)。结论PAI-1、DD及两者联合检测对于COPD合并PTE的有诊断价值,尤其是联合检测对COPD合并PTE的诊断具有重要意义。

Objective To evaluate the value of plasma tissue plasminogen activator inhibitor-l, D-dimer in diagnosis of chronic obstructive pulmonary disease combined pulmonary thromDoembolism. Methods Plasma concentrations of PAI-1, D-dimer in COPD merged PTE group and COPD patients were compared, clinical diagnostic sensitivity, specificity and ROC area under the curve of plasma PAI-1,D-dimer in COPD combined pulmonary thromboembolism by ROC curve were analyzed Results Levels of plasma PAI-1 ,D-dimer in COPD combined PTE group were significantly higher than the COPD group. The sensitivity and accuracy of the combined determination containing PAI-1 and D-dimer test were 87.6%, 85.6% by 98.5ng / L, 1.85mg / L for the positive point in COPD combined PTE group. The sensitivity and specificity of combined detection were significantly higher than PAI-1 or DD single detection （P〈0.05）. Conclusion Combined detection of PAI-1 and DD can significantly improve the sensitivity and the accuracy in diagnosis of COPD combined FIE.