Wells评分联合D-二聚体检测在深静脉血栓诊断中的应用

Wells' score combined with D-dimer determination for screening deep vein thrombosis

目的探讨深静脉血栓(DVT)形成的临床概率模型Wells评分联合D-二聚体(DD)测定在筛查DVT中的临床应用价值。方法对127例疑似DVT患者进行Wells评分,得出预测概率得分,同时测定其治疗前DD水平,最后根据彩色多普勒超声及多层螺旋CT静脉造影术明确诊断。结果 Wells评分筛查DVT的阳性率为30.7%,DD筛查DVT的阳性率为36.2%,两者联合筛查DVT的阳性率为47.2%,联合筛查的阳性率明显高于Wells评分和DD单项筛查(P<0.05)。DD筛查的性能优于Wells评分(P<0.05)。结论 Wells评分联合DD检测可辅助早期筛查DVT,降低DVT漏诊率,并有效排除DVT。

Objective To investigate the significance of clinical probability model Wells＇ score combined with D-dimer（DD）determination for screening deep vein thrombosis（DVT）. Methods A total of 127 patients with suspected DVT were enrolled for Wells＇ score,and the prediction probability score was obtained. DD level before treatment was determined. According to the color Doppler flow imaging and multislice CT venography,the further diagnosis was performed. Results The positive rate of Wells＇ score for screening DVT was 30.7%,and the positive rate of DD determination was 36.2%. The positive rate of combined determination for screening DVT was 47.2%,which was higher than those of Wells＇ score and DD determination（P〈0.05）. The performance of DD determination was better than that of Wells＇ score（P〈0.05）. Conclusions Wells＇ score combined with DD determination can help for the early screening of DVT,reduce miss diagnosis rate,and effectively eliminate DVT.