检测血浆D-二聚体改善低密度脂蛋白预测冠心病的准确性

Detection of plasma D-dimer improves the accuracy of low density lipoprotein in predicting coronary heart disease

目的探讨血浆D-二聚体(D-D)协助低密度脂蛋白(LDL)预测冠心病的可能性。方法选取武汉大学人民医院2015年1~12月住院治疗经心血管造影确诊的冠心病患者400例,平均年龄(62.90±5.70)岁;非冠心病体检者55例,平均年龄(50.40±7.60)岁。使用SIEMENS ADVIA-2400全自动生化分析仪测定LDL水平,SYSMEX CA7000血凝仪测定D-D水平,ROC曲线分析两者与冠心病之间的关系。结果 ROC曲线显示50~70岁患者中LDL诊断冠心病有60%的特异性和77%的灵敏度,而D-D水平不能有效诊断冠心病;当考虑以D-D水平弥补LDL水平诊断的不足可以提高诊断质量,尤其以0.2 mg/L的D-D水平为判断标准时,诊断的特异性可达76.9%,灵敏度可达84.6%。结论血浆D-D水平的检测可以改善LDL水平对冠心病预测的准确性。

Objective To investigate the possibility of plasma D-dimer（D-D） in helping low density lipoprotein（LDL） to predict coronary heart disease（CHD）. Methods The confirmed patients with CAD by coronary angiography（400 cases） and physical examination persons（55 cases） are collected. The mean ages were respectively（62.90 ±5.70） and（50.40 ± 7.60） years old. The relationships among CAD and the LDL and D-D levels were analyzed by ROC curve. Results ROC curves showed a specificity of 60% and a sensitivity of 77% in diagnosis of CHD patients from 50 to 70 years, but the level of D-D was not effective in the diagnosis of CHD. The quality of LDL level diagnosis can be improved by using D-D levels to make up its shortage. Especially, when 0.2 mg/L of D-D level was taken as positive standard, the diagnostic specificity can reach 76.9%, and the sensitivity can reach 84.6%. Conclusion Detection of plasma D-D level can improve the accuracy of LDL levels in predicting CHD.