动脉血二氧化碳分压联合修正版Geneva评分对急性肺栓塞的联合预测效能

Combined prediction efficiency of arterial partial pressure of carbon dioxide combined with modified Geneva score on acute pulmonary embolism

目的:探讨动脉血二氧化碳分压(Partial pressure of carbon dioxide,PaCO_(2))联合修正版Geneva评分对急性肺栓塞(Pulmonary embolism,APE)的联合预测效能。方法:回顾性分析2019年1月至2022年12月于我院进行治疗的疑似急性肺栓塞患者的临床资料265例。据计算机断层扫描肺血管造影术(Computed tomography pulmonary angiography,CTPA)检查结果将265例患者分为APE组(CPTA阳性)与Non-APE组(CPTA阴性),其中APE组138例,Non-APE组127例。收集并对比两组患者的临床资料,并分析PaCO_(2)联合修正版Geneva评分的联合预测效能。结果:APE组与Non-APE组患者的呼吸困难、咳血、晕厥、胸痛症状分布差异无统计学意义。APE组患者修正版Geneva评分分布明显高于Non-APE组(P<0.05);APE组PaCO_(2)<35 mmHg的患者明显多于Non-APE组(P<0.05)。PaCO_(2)联合修正版Geneva评分对于急性肺栓塞预测的曲线下面积(Area Under Curve,AUC)、95%CI高于单独指标。结论:PaCO_(2)联合修正版Geneva评分预测急性肺栓塞的曲线下面积显著高于单一指标,其敏感度显著优于单独修正版Geneva评分系统,特异度优于PaCO_(2)。

Objective:To investigate the combined prediction efficiency of Partial pressure of carbon dioxide(PaCO_(2))and modified Geneva score on acute pulmonary embolism(APE).Methods:Clinical data of 265 suspected APE patients treated in our hospital from January 2019 to December 2022 were retrospectively analyzed.According to the results of computed tomography pulmonary angiography(CTPA)examination,265 patients were divided into APE group(CPTA positive)and Non-APE group(CPTA negative),among which 138 patients were in APE group and 127 patients were in Non-APE group.Clinical data of the two groups were collected and compared;and the combined prediction efficiency of PaCO_(2) and modified Geneva score was analyzed.Results:There were no significant differences in the distribution of dyspnea,hemoptysis,syncope and chest pain between APE group and Non-APE group.The distribution of modified Geneva scores in APE group was significantly higher than that in Non-APE group(P<0.05);patients with PaCO_(2)<35mmHg in APE group were significantly more than those in Non-APE group(P<0.05).The predicted Area Under Curve(AUC)and 95%CI of PaCO_(2) combined with modified Geneva score for APE were higher than those of the single index.Conclusion:The AUC of PaCO_(2) combined with modified Geneva score is significantly higher than that of single index,its sensitivity is significantly better than that of modified Geneva score system alone,and its specificity is significantly better than that of PaCO_(2) alone.