D-二聚体和纤维蛋白原水平预测支气管动脉栓塞术治疗支气管扩张大咯血临床疗效及预后的临床价值

Clinical Value of D-dimer and Fibrinogen Levels in Predicting the Clinical Efficacy and Prognosis of Bronchial Artery Embolization in the Treatment of Bronchiectasis with Massive Hemoptysis

目的:探讨D-二聚体和纤维蛋白原水平预测支气管动脉栓塞术治疗支气管扩张大咯血的临床疗效及预后的临床价值。方法:选取50例2011年11月至2016年11月期间于我院治疗的支气管扩张大咯血患者进行研究,所有患者均进行支气管动脉栓塞术治疗,根据临床疗效评价标准结果分为总有效组(n=40)和无效组(n=10),随访1年,根据预后的复发情况分为预后好组(n=38)和预后差组(n=12),分别比较总有效组和无效组、预后好组和预后差组D-二聚体和纤维蛋白原水平,采用受试者工作特征(ROC)曲线分析D-二聚体和纤维蛋白原对支气管扩张大咯血患者的预测价值。结果:手术后总有效组和无效组患者D-二聚体、纤维蛋白原水平均高于手术前,且总有效组高于无效组(P<0.05)。手术后预后好组和预后差组患者D-二聚体、纤维蛋白原水平均高于手术前,且预后好组高于预后差组(P<0.05)。ROC曲线分析显示,D-二聚体和纤维蛋白原对支气管扩张大咯血患者均具有较高的敏感度和特异度,曲线下面积分别为0.725和0.806。结论:采用支气管动脉栓塞术治疗支气管扩张大咯血,疗效及预后比较好的患者D-二聚体和纤维蛋白原水平均较高,并且其敏感度和特异度较高,具有一定的临床预测价值。

Objective:To investigate the clinical value of D-dimer and fibrinogen levels in predicting the clinical efficacy and prognosis of bronchial artery embolization in the treatment of bronchiectasis with massive hemoptysis.Methods:50 patients with massive hemoptysis due to bronchiectasis treated in our hospital from November 2011 to November 2016 were selected for the study,all patients underwent bronchial artery embolization.According to the results of clinical evaluation criteria,the patients were divided into total effective group(n=40)and ineffective group(n=10).Following up for 1 year,the patients were divided into good prognosis group(n=38)and poor prognosis group(n=12)according to the recurrence of prognosis.D-dimer and fibrinogen levels in total effective group and ineffective group,good prognosis group and poor prognosis group were compared respectively,the predictive value of D-dimer and fibrinogen in patients with massive hemoptysis due to bronchiectasis were analyzed by receiver operating characteristic(ROC)curve.Results:D-dimer and fibrinogen levels in the total effective group and the ineffective group after operation were higher than those before operation,and the total effective group were higher than the ineffective group(P<0.05).D-dimer and fibrinogen levels in the good prognosis group and poor prognosis group after operation were higher than those before operation,and the good prognosis group were higher than the poor prognosis group(P<0.05).ROC curve showed that both D-dimer and fibrinogen had high sensitivity and specificity in patients with massive hemoptysis due to bronchiectasis,the areas under the curve were 0.725 and 0.806 respectively.Conclusion:The D-dimer and fibrinogen levels in patients with massive hemoptysis due to bronchiectasis treated by bronchial artery embolization are higher,and their sensitivity and specificity are higher,which has certain clinical predictive value.