本文選題：肺栓塞　切入點(diǎn)：D-二聚體　出處：《浙江大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 探討隨年齡調(diào)整的D-二聚體臨界值標(biāo)準(zhǔn)在急性肺栓塞診斷中的價值。方法： 以螺旋CT肺動脈造影為診斷標(biāo)準(zhǔn),檢測1056例疑似肺栓塞患者D-二聚體濃度,分別計(jì)算傳統(tǒng)標(biāo)準(zhǔn)組和隨年齡調(diào)整的臨界值標(biāo)準(zhǔn)組的敏感性、特異性、準(zhǔn)確性、陰性預(yù)測值及陽性預(yù)測值。結(jié)果： 按傳統(tǒng)D-二聚體標(biāo)準(zhǔn)判斷結(jié)果,陰性352例,陽性704例,其中真陽性156例,真陰性343例,按新的D-二聚體標(biāo)準(zhǔn)判斷結(jié)果,陰性474例,陽性582例,其中真陽性156例,真陰性465例。兩者的敏感性、特異性、準(zhǔn)確性、陰性預(yù)測值及陽性預(yù)測值,前者依次為94.55%、38.50%、47.25%、97.44%、22.16%,后者依次為94.55%、52.19%、58.81%、98.10%、26.80%,兩者在敏感性相同的情況下,后者的特異性和準(zhǔn)確性均較前者明顯升高,尤其是特異性增加了13.69%,兩者的Youden指數(shù)有顯著性差異(Z=4.58,P0.01)。 結(jié)論： 應(yīng)用隨年齡調(diào)整的D-二聚體臨界值標(biāo)準(zhǔn),提高了D-二聚體檢測在老年急性肺栓塞診斷中的特異性,并且同時沒有降低敏感性。
[Abstract]:Objective:. To investigate the value of age-adjusted threshold of D-dimer in the diagnosis of acute pulmonary embolism. The D-dimer concentration of 1056 suspected pulmonary embolism patients was detected by spiral CT pulmonary angiography, and the sensitivity, specificity and accuracy of the traditional standard group and the age-adjusted critical value standard group were calculated, respectively. Negative predictive value and positive predictive value. Results:. According to traditional D- dimer criteria, 352 cases were negative, 704 cases were positive, 156 cases were true positive, 343 cases were true negative, 474 cases were negative and 582 cases were positive according to the new standard, 156 cases were true positive. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of the two groups were 94.55, 38.50, 47.257.44 and 22.16, respectively, and the latter were 94.5552.191.58.81and 98.100.80, respectively. The specificity and accuracy of the latter were significantly higher than those of the former. In particular, the specificity was increased by 13.699.The Youden index of the two groups was significantly different from that of 4.58% (P 0.01). Conclusion:. The application of age-adjusted threshold of D-dimer improved the specificity of D-dimer in the diagnosis of acute pulmonary embolism in the elderly, and did not decrease the sensitivity at the same time.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.5

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