4种肺栓塞预测方法在基层医院肺栓塞高危人群风险筛查中的效果比较

Comparison of effects of four predictive methods for pulmonary embolism in risk screening of highrisk population with pulmonary embolism in primary hospitals

目的比较Wells评分、改良Geneva评分、ZS评分及YEARS法在基层医院肺栓塞高危人群中的筛查效果。方法采用便利抽样法,收集2017年1月—2018年12月于河南科技大学第一附属医院进行诊治的165例疑似肺栓塞患者的临床资料,分别采用Wells评分、改良Geneva评分、ZS评分及YEARS法进行评估,比较不同方法诊断肺栓塞的灵敏度、特异度及准确率,绘制ROC,并计算曲线下面积(AUC)。结果经高分辨螺旋CT肺动脉血管造影术(CTPA)检测确诊栓塞者49例,非肺栓塞者116例。肺栓塞患者Wells评分、改良Geneva评分和ZS评分均高于非肺栓塞者(t值分别为32.614、31.585、28.648;P<0.01)。ZS评分评估肺栓塞的AUC为(0.873±0.034),均大于改良Geneva评分、Wells评分及YEARS法。结论ZS评分对基层医院高危肺栓塞患者的预测具有较好的临床价值,总体上优于改良Geneva评分、Wells评分及YEARS法。

Objective To compare the screening effects of Wells score,modified Geneva score,ZS score and YEARS method in high-risk population with pulmonary embolism in primary hospitals.Methods By the convenient sampling method,clinical data of 165 patients with suspected pulmonary embolism who were diagnosed and treatment in the First Affiliated Hospital of Henan University of Science and Technology from January 2017 to December 2018 were collected,and data were evaluated by Wells score,modified Geneva score,ZS score and YEARS method,respectively.The sensitivity,specificity and accuracy of different methods for diagnosis of pulmonary embolism were compared.ROC curve was drawn and area under the curve(AUC)was calculated.Results CT pulmonary angiography(CTPA)test confirmed embolism in 49 cases,non-pulmonary embolism in 116 cases.The Wells score,modified Geneva score and ZS score of patients with pulmonary embolism were higher than those of non-pulmonary embolism(t=32.614,31.585,28.648;P<0.01).The AUC of ZS score for evaluating pulmonary embolism was(0.873±0.034),which was greater than modified Geneva score,Wells score,and YEARS method.Conclusions ZS score has better clinical value for predicting highrisk pulmonary embolism patients in primary hospitals,and it is generally better than modified Geneva score,Wells score and YEARS method.