This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with p...This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.展开更多
目的探讨Padua评分及D-二聚体对2型糖尿病内科住院患者急性肺栓塞的预测价值。方法回顾性分析2013年1月-2016年3月解放军第474医院临床疑诊急性肺栓塞(APE)的2型糖尿病内科住院患者151例,应用R O C曲线分析法比较Padua评分及D-二聚体对...目的探讨Padua评分及D-二聚体对2型糖尿病内科住院患者急性肺栓塞的预测价值。方法回顾性分析2013年1月-2016年3月解放军第474医院临床疑诊急性肺栓塞(APE)的2型糖尿病内科住院患者151例,应用R O C曲线分析法比较Padua评分及D-二聚体对2型糖尿病内科住院患者急性肺栓塞的预测价值。结果 Padua评分诊断2型糖尿病内科住院患者APE的最佳分界值4分,≥4分时灵敏度66.25%,特异度84.51%,约登指数0.51,ROC曲线下面积为0.804(95%CI=0.735~0.874);D-二聚体最佳分界值0.5 mg/L,≥0.5 mg/L时灵敏度72.5%,特异度62.5%,约登指数0.35,D-D诊断2型糖尿病内科住院患者APE的ROC曲线下面积为:0.675(95%CI=0.597~0.747)。Padua评分联合D-D诊断2型糖尿病内科住院患者APE的灵敏度82.35%,特异度63.94%,约登指数0.525,ROC曲线下面积:0.812(95%CI=0.736~0.853)。结论 Padua评分对2型糖尿病内科住院患者APE的预测价值特异度高,但灵敏度差,不理想。而D-二聚体对2型糖尿病内科住院患者APE的预测价值灵敏度高,特异性差。两者联合可提高预测价值,有助于临床医师早期发现糖尿病APE高危人群。展开更多
基金Sichuan Province Medical Research Project Plan(Project No.S21113)。
文摘This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.
