Caprini量表联合D-二聚体检测对患者发生急性肺栓塞风险的早期预测价值研究

Early predictive value of Caprini scale combined with D-dimer detection in the risk of acute pulmonary embolism in patients

目的分析Caprini量表联合D-二聚体检测对患者发生急性肺栓塞(APE)风险的早期预测价值。方法选取2018年10月至2019年10月以胸闷气短为首发症状就诊于广西壮族自治区百色市人民医院的135例患者,其中确诊APE的70例患者作为观察组,疑似为APE但临床排除的65例患者作为对照组。比较2组Caprini量表评分与D-二聚体水平,分析Caprini量表评分、D-二聚体水平及二者联合早期预测APE发生风险的价值。结果观察组Caprini量表评分及D-二聚体水平均高于对照组[(5.34±1.62)分比(1.34±0.22)分、(1.32±0.24)mg/L比(0.44±0.12)mg/L],差异均有统计学意义(t=3.928,P=0.031;t=4.000,P=0.025)。Caprini量表和D-二聚体预测APE发生风险的临界值分别为1.568分、1.5 mg/L,受试者工作特征曲线下面积及95%置信区间分别为0.834(0.832~0.916)、0.811(0.735~0.881),二者联合的曲线下面积及95%置信区间为0.956(0.743~0.982)。Caprini量表联合D-二聚体预测APE发生风险的敏感度、特异度、曲线下面积均高于Caprini量表及D-二聚体单独检测(均P<0.05)。结论Caprini量表联合D-二聚体检测对APE发生具有较高的早期预测价值,且简便易行,对医师诊断APE具有一定借鉴意义。

Objective To analyze the early predictive value of Caprini scale combined with D-dimer detection in the risk of acute pulmonary embolism(APE)in patients.Methods From October 2018 to October 2019,135 patients with chest tightness and shortness of breath as the first symptom admitted to People’s Hospital of Baise,Guangxi Zhuang Autonomous Region were selected.Among them,70 patients diagnosed as APE were divided into the observation group,and 65 patients suspected of APE but clinically excluded were divided into the control group.Caprini scale score and D-dimer level were compared between the two groups,and the value of Caprini scale score,D-dimer level and their combination in early prediction of APE risk was analyzed.Results The Caprini scale score and D-dimer level of the observation group were higher than those of the control group[(5.34±1.62)vs(1.34±0.22),(1.32±0.24)mg/L vs(0.44±0.12)mg/L](t=3.928,P=0.031;t=4.000,P=0.025).The cut-off values of Caprini scale and D-dimer were 1.568 and 1.5 mg/L to predict the risk of APE,respectively.The area under the receiver operating characteristic curve and 95%confidence interval were 0.834(0.832-0.916)and 0.811(0.735-0.881),respectively;the combined area under the curve and 95%confidence interval were 0.956(0.743-0.982).The sensitivity,specificity and the area under the curve of Caprini scale combined with D-dimer were higher than those of Caprini scale and D-dimer alone in predicting the risk of APE(all P<0.05).Conclusion Caprini scale combined with D-dimer detection has high early predictive value in APE,and it is simple and easy to operate,which has a certain reference significance for physicians to diagnose APE.