320排CT肺血管减影成像联合NT-proBNP诊断急性肺栓塞的临床应用

Clinical Application of 320-slice CT Digital Subtraction Pulmonary Angiography Combined with NT-proBNP in the Diagnosis of Acute Pulmonary Embolism

目的:探讨320排CT肺血管减影成像联合NT-proBNP诊断急性肺栓塞的临床价值。方法:以2020年9月-2021年2月本院收治的54例疑似急性肺栓塞患者为研究对象,采集患者入院空腹外周静脉血,电化学发光法检测血浆NT-proBNP水平,同时予以患者320排CT扫描及肺动脉造影,获取减影后肺动脉血管图像与碘分布融合肺动脉图像,观察肺动脉血管显影与血流量情况,记录栓子数目与位置。以肺动脉造影术诊断结果为金标准,评价CT肺血管减影成像与NT-proBNP诊断急性肺栓塞的灵敏度、特异度与准确性。结果:基于金标准,CT肺血管减影成像诊断急性肺栓塞误诊2例、漏诊2例,NT-proBNP诊断急性肺栓塞漏诊4例、误诊7例。CT肺血管减影成像与NT-proBNP联合诊断急性肺栓塞,漏诊1例,误诊1例。经计算,联合诊断灵敏度92.86%、特异度97.50%、准确率96.30%,高于CT肺血管减影成像与NT-proBNP单一诊断。结论:320排CT肺血管减影成像是诊断急性肺栓塞有效可行的方法,联合NT-proBNP检测,可进一步提高诊断准确性。

Objective:To explore the clinical value of 320-slice CT digital subtraction pulmonary angiography combined with NT-proBNP in the diagnosis of acute pulmonary embolism.Method:A total of 54 patients with suspected acute pulmonary embolism admitted to our hospital from September 2020 to February 2021 were selected as the research objects,the fasting peripheral venous blood of patients was collected,and the plasma NT-proBNP level was detected by electro chemiluminescence method,at the same time,320 CT scans and pulmonary angiography were given to patients,the subtraction pulmonary artery image and iodine distribution fusion pulmonary artery image were obtain,the pulmonary artery vascular imaging and blood flow were observed,the number and location of emboli were recorded.The diagnosis result of pulmonary angiography was used as the gold standard to evaluate the sensitivity,specificity and accuracy of CT digital subtraction pulmonary angiography and NT-proBNP in the diagnosis of acute pulmonary embolism.Result:Based on the gold standard,CT digital subtraction pulmonary angiography was misdiagnosed in 2 cases and 2 cases were missed in the diagnosis of acute pulmonary embolism,while NT-proBNP diagnosed acute pulmonary embolism in 4 cases and 7 cases were misdiagnosed.CT digital subtraction pulmonary angiography combined with NT-proBNP in the diagnosis of acute pulmonary embolism,1 case was missed and 1 case was misdiagnosed.After calculation,the sensitivity of combined diagnosis was 92.86%,the specificity was 97.50%,and the accuracy was 96.30%,which were higher than those of CT pulmonary angiography and NT-proBNP single diagnosis.Conclusion:320-slice CT digital subtraction pulmonary angiography is an effective and feasible method for the diagnosis of acute pulmonary embolism,combined with NT-proBNP detection can further improve the diagnostic accuracy.