联合检测活化蛋白C-蛋白C抑制物复合物、D-二聚体对静脉血栓栓塞症的诊断价值

Diagnostic value of combined detection of activated protein C and protein C inhibitor compounds and D-dimer in venous thromboembolism

目的探究活化蛋白C-蛋白C抑制物复合物(APC-PCI)、D-二聚体联合检测对静脉血栓栓塞症(VTE)的诊断价值。方法 81例疑诊VTE的患者,检测血浆D-二聚体及APC-PCI复合物浓度,经过影像学确诊31例VTE。分析两者对VTE的诊断价值。结果 VTE患者血浆APC-PCI复合物浓度显著高于非VTE组。以0.88ng/mL为诊断界值,敏感性为64.5%,特异性为86%,以0.5μg/mL为D-二聚体界值,敏感性为92.3%,特异性为66.7%。两者串联检测,特异性90%,阳性预测值78.3%;并联检测可显著提高敏感性和阴性预测值。结论 APC-PCI复合物浓度在VTE中显著升高,与D-二聚体联合检测后可提升阳性和阴性预测值,有利于高危人群的床旁快速诊断和鉴别。

Objective To explore the diagnostic value of combined detection of APC-PCI and D-dimmer in the diagnosis of venous thromboembolism （VTE）. Methods 81 cases of suspected venous thromboembolism were collected. Their plasma levels of D-dimer and APC-PCI complexes were detected after admission. 31 cases were fi- nally diagnosed as VTE by imageological examination. The diagnostic value of the two groups of VTE was analyzed. Results The plasma concentrations of APC-PCI in VTE patients were significantly higher than those in non VTE group. Taking 0. 88ng/mL as the cut-off value in the diagnosis of VTE, the sensitivity was 64. 5%, and the specifici- ty was 86%. Taking 0. 5 g/mL as the cut-off value of D-dimer, the sensitivity was 92. 3%, and the specificity was 66. 7%. The specificity of the combined detection was 90%, and the positive predictive value was 78.3%. Conclu- sion APC-PCI compound increases significantly in VTE, and the combined detection of APC-PCI complex and D-di- met can improve the positive and negative predictive value, which can conducive to the high risk population of rapid bedside diagnosis and differential diagnosis.