Caprini评分联合D-二聚体诊断肺栓塞的价值

Value of Caprini scores combined with D-dimer for diagnosis of pulmonary embolism

目的评价Caprini评分联合D-二聚体在诊断肺栓塞中的应用价值。方法回顾性分析2017年1～12月河南省人民医院收治的134例肺栓塞患者及130例同期住院无肺栓塞患者的临床资料。分析Caprini评分、D-二聚体及Caprini评分联合D-二聚体诊断肺栓塞的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比和约登指数。结果 Caprini评分诊断肺栓塞的灵敏度为88. 95%,特异度为84. 62%,阳性预测值为85. 71%,阴性预测值为88. 71%,阳性似然比为5. 78,阴性似然比为0. 12,约登指数为73. 57。D-二聚体诊断肺栓塞的灵敏度为82. 84%,特异度为75. 38%,阳性预测值为77. 62%,阴性预测值为80. 99%,阳性似然比为3. 36,阴性似然比为0. 23,约登指数为58. 22。Caprini评分联合D-二聚体诊断肺栓塞的灵敏度为93. 28%,特异度为91. 54%,阳性预测值为91. 91%,阴性预测值为92. 97%,阳性似然比为11. 03,阴性似然比为0. 07,约登指数为84. 82。Caprini评分联合D-二聚体诊断肺栓塞的阳性似然比高于Caprini评分、D-二聚体单独诊断(χ~2=3. 902、14. 931,P <0. 05),阴性似然比低于Caprini评分、D-二聚体单独诊断(χ~2=5. 261、16. 782,P <0. 05)。结论 Caprini评分联合D-二聚体检测诊断肺栓塞的准确性高。

Objective To analyze the value of Caprini scores combined with D-dimer for the diagnosis of pulmonary embolism( PE). Methods The clinical data of 134 patients with PE and 130 patients without PE in the Henan Provincial People’s Hospital from January 2017 to December 2017 was analysed retrospectively. The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and Youden’ index was used to evaluate the value of Caprini scores,D-dimer and Caprini scores combined with D-dimer in the diagnosis of PE. Results The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and Youden’ index values of Caprini scores to diagnose PE was 88. 95%,84. 62%,85. 71%,88. 71%,5. 78,0. 12,73. 57,respectively. The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and Youden’ index values of Caprini scores to diagnose PE was 82. 84%,75. 38%,77. 62%,80. 99%,3. 36,0. 23,58. 22,respectively. The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and Youden’ index values of Caprini scores combined with D-dimer to diagnose PE was93. 28%,91. 54%,91. 91%,92. 97%,11. 03,0. 07,84. 82. The positive likelihood ratio of Caprini score combined with Ddimer in the diagnosis of PE was higher than that of Caprini score and D-dimer alone( χ~2= 3. 902,14. 931;P < 0. 05),while the negative likelihood ratio was lower than that of Caprini score and D-dimer alone( χ~2= 5. 261,16. 782;P < 0. 05).Conclusion Caprini scores combined with D-dimer highly likely has more accurate predictive value for the diagnosis of PE.