彩色多普勒超声联合D-二聚体对下肢动脉血管栓塞的诊断价值分析

Analysis of the value of color Doppler ultrasonography combined with D-dimer in the diagnosis of lower extremity arterial embolism

目的 探讨彩色多普勒超声联合D-二聚体对下肢动脉血管栓塞的诊断价值。方法 选取80例疑似下肢动脉血管栓塞患者,分别进行彩色多普勒超声检查和D-二聚体检测。比较下肢动脉血管栓塞患者和非下肢动脉血管栓塞患者D-二聚体水平;比较彩色多普勒超声、D-二聚体及彩色多普勒超声联合D-二聚体的诊断结果。结果 56例下肢动脉血管栓塞患者D-二聚体为(1585.26±294.23)μg/L,24例非下肢动脉血管栓塞患者D-二聚体为(575.52±174.23)μg/L;下肢动脉血管栓塞患者D-二聚体水平显著高于非下肢动脉血管栓塞患者,差异有统计学意义(P<0.05)。以数字减影血管造影检查(DSA)诊断为金标准,彩色多普勒超声诊断灵敏度和准确率与D-二聚体及彩色多普勒超声联合D-二聚体比较,差异均无统计学意义(P>0.05);D-二聚体诊断灵敏度与彩色多普勒超声联合D-二聚体比较,差异无统计学意义(P>0.05);彩色多普勒超声和彩色多普勒超声联合D-二聚体诊断特异度分别为95.83%、95.83%,均显著高于D-二聚体的66.67%,差异有统计学意义(P<0.05);彩色多普勒超声联合D-二聚体诊断准确率97.50%高于D-二聚体的86.25%,差异有统计学意义(P<0.05)。结论 采用彩色多普勒超声联合D-二聚体诊断可进一步提升下肢动脉血管栓塞的诊断准确性,可为临床诊疗提供有效的参考数据。

Objective To discuss the value of color Doppler ultrasonography combined with D-dimer in the diagnosis of lower extremity arterial embolism.Methods 80 patients with suspected lower extremity arterial embolism were selected,and all tested by color Doppler ultrasonography and D-dimer.Comparison was made on D-dimer between patients with and without arterial embolism of lower extremity,and the diagnostic results of color Doppler ultrasonography,D-dimer and color Doppler ultrasonography combined with D-dimer.Results The D-dimer of 56 patients with lower extremity arterial embolism was(1585.26±294.23)μg/L,and the D-dimer of 24 patients without lower extremity arterial embolism was(575.52±174.23)μg/L.The D-dimer in patients with lower extremity arterial embolism was significantly higher than that of patients without lower extremity arterial embolism,and the difference was statistically significant(P<0.05).With digital subtraction angiography(DSA)as the gold standard for diagnosis,the diagnostic sensitivity and accuracy of color Doppler ultrasonography were not statistically different from those of D-dimer and color Doppler ultrasonography combined with D-dimer(P>0.05);there was no statistically significant difference in the diagnostic sensitivity between D-dimer and color Doppler ultrasonography combined with D-dimer(P>0.05).The diagnostic specificity of color Doppler ultrasonography and color Doppler ultrasonography combined with D-dimer were 95.83%and 95.83%,respectively,which were significantly higher than 66.67%of D-dimer,and the differences were statistically significant(P<0.05).The diagnostic accuracy 97.50%of color Doppler ultrasonography combined with D-dimer was higher than 86.25%of D-dimer,and the difference was statistically significant(P<0.05).Conclusion D-dimer combined with color Doppler ultrasonography can further improve the diagnostic accuracy of lower extremity arterial embolism,so as to provide effective reference data for clinical diagnosis and treatment.