彩色多普勒超声与D-二聚体检测在下肢深静脉血栓诊断中的应用

The Application of Color Doppler Ultrasound and Plasma D-dimer Test in the Diagnosis of the Deep Venous Thrombosis of Lower Extremities

目的:探讨彩色多普勒超声与D-二聚体检测在下肢深静脉血栓(DVT)诊断中的应用。方法:对400例临床怀疑DVT的患者进行彩色多普勒超声检查及D-二聚体检测。两种诊断方法单独诊断DVT及联合诊断DVT的结果与下肢静脉造影的诊断结果进行比较,并以下肢静脉造影为标准,分别计算彩色多普勒超声与D-二聚体检测对DVT的诊断效能。结果:彩色多普勒超声诊断DVT的敏感性为94.4%,特异性为98.9%,阳性预测值为97.1%,阴性预测值为98.0%,诊断准确率为97.8%;D-二聚体检测诊断DVT的敏感性为96.3%,特异性为89.4%,阳性预测值为77.0%,阴性预测值为98.5%,诊断准确率为91.3%;彩色多普勒超声与D-二聚体检测联合诊断DVT的敏感性为96.3%,特异性为100%,阳性预测值为100%,阴性预测值为98.6%,诊断准确率为99.0%。结论:彩色多普勒超声具有较高的特异性、阳性预测值及诊断准确性,可以作为临床诊断DVT的首选辅助检查;D-二聚体检测具有较高的阴性预测值,可以作为临床诊断DVT的预测指标。两者联合使用诊断DVT的敏感性及特异性更高,具有更高的诊断价值。

Objective:To investigate the application of color Doppler ultrasound and plasma d-dimer test in the diagnosis of deep venous thrombosis of lower extremities(DVT).Methods:Color Doppler ultrasonography and D-dimeric examination were performed on 400 patients with suspected DVT. The results of separate diagnosis of DVT and joint diagnosis of DVT were compared with those of lower extremity venography, and the diagnostic efficacy of color Doppler ultrasonography and D-dimerization were calculated by using lower extremity venography as the standard.Results:The sensitivity of color Doppler ultrasound in diagnosing DVT was 94.4 %, specificity 98.9 %, positive prediction was 97.1 %, negative prediction was 98.0 %, and diagnostic accuracy was 97.8 %;The sensitivity of D-dimeric diagnostic DVT was 96.3 %, specificity was 89.4 %, the positive prediction value was 77.0 %, the negative prediction value was 98.5 %, and the diagnostic accuracy rate was 91.3 %;The sensitivity, specificity, positive prediction, negative prediction, 98.6 %, and diagnostic accuracy were 96.3 %, 100 %, and 99.0 %.Conclusion:Color Doppler ultrasound has high specificity, positive predictive value and diagnostic accuracy, which can be used as the first choice for clinical diagnosis of DVT. Plasma d-dimer test has high negative predictive value and can be used as a predictor of clinical diagnosis of DVT. The combination of the two uses the diagnostic DVT with higher sensitivity and specificity, and has higher diagnostic value.