彩色多普勒超声联合D-二聚体对周围型下肢深静脉血栓筛查的价值

Color Doppler ultrasound combined with D-dimer in screening of peripheral lower extremity deep venous thrombosis

目的探讨彩色多普勒超声(CDUL)联合D-二聚体检测对周围型下肢深静脉血栓的筛查价值。方法对1821例下肢深静脉血栓的高危患者行下肢深静脉CDUL检查及D-二聚体的检测。分别计算CDUL、血浆D-二聚体浓度水平检测以及二者联合对高危人群中周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值以及Kappa值。结果CDUL诊断周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值、Kappa值为95.8%、94.5%、88.2%、98.1%、0.881。血浆D-二聚体浓度检测诊断周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值、Kappa值为85.2%、95.6%、89.3%、93.8%、0.818。二者联合诊断周围型下肢深静脉血栓形成的灵敏度、特异度、阳性预测值、阴性预测值、Kappa值为98.0%、100.0%、100.0%、99.1%、0.986。CDUL联合D-二聚体检测与单独行D-二聚体检测及CDUL检查的差异均有统计学意义(均P<0.05)。结论CDUL检查联合血清D-二聚体检测对筛查周围型下肢深静脉血栓有较高的诊断准确率,具有较高的临床价值。

Objective To investigate the value of color Doppler ultrasound combined with plasma D-dimer in screening of peripheral lower extremity deep venous thrombosis.Methods From september 2017 to September 2019,1821 high-risk patients of peripheral deep venous thrombosis of lower extremities were examined with color Doppler detection and D-dimer examination.The sensitivity,specificity,positive predictive value,negative predictive value and Kappa of color Doppler examination and plasma D-dimer level to peripheral deep venous thrombosis of lower extremities were calculated with statistical methods respectively.ResultsThe sensitivity,specificity,positive predictive value,negative predictive value and Kappa of color Doppler examination in the diagnosis of peripheral deep venous thrombosis of lower extremities were 95.8%,94.5%,88.2%,98.1%,0.881,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and Kappa of plasma D-dimer concentration in the diagnosis of peripheral deep venous thrombosis of lower extremities were 85.2%,95.6%,89.3%,93.8%,0.818.The sensitivity,specificity,positive predictive value,negative predictive value and Kappa were 98.0%,100.0%,100.0%,99.1%,0.986 with the combination of the two methods.The differences between color Doppler ultrasound combined with plasma D-dimer and these two methods,separately,were statistically significant(all P<0.05).Conclusion The application of color Doppler ultrasound combined with plasma D-dimer examination has high accuracy rate and clinical value in screening peripheral deep venous thrombosis.