肺CTPA联合D-二聚体检测对急诊肺栓塞的诊断研究

doi:10.7517/issn.1674-0475.210514

摘要/Abstract

摘要： 本文探讨应用CT肺动脉造影（CTPA）联合D-二聚体诊断急诊肺栓塞的价值。选取疑似肺栓塞患者108例为研究对象，均在行CTPA、D-二聚体检查。肺栓塞患者血清D-二聚体水平明显高于非肺栓塞患者（P<0.05）；D-二聚体预测肺栓塞的ROC曲线下面积为0.921，P<0.05；D-二聚体≥2.50 μg/mL患者CTPA肺栓塞检出率明显高于D-二聚体<2.50 μg/mL患者（P<0.05）；肺栓塞患者CPTA间接征象中，不规则形实变影、肺不张影级下腔静脉返流高于非肺栓塞患者（P<0.05）；肺栓塞患者D-二聚体与CT肺动脉栓塞指数（CTI%）呈正相关（r=0.684，P<0.05）。CTPA联合D-二聚体检测在急诊肺栓塞诊断中有较好的应用价值，尤其在D-二聚体水平≥2.50 μg/mL患者中CTPA肺栓塞检出率高。

关键词: CT肺动脉造影, D-二聚体, 急诊肺栓塞, 诊断价值

Abstract: The purpose of this study was to investigate the value of CT pulmonary angiography (CTPA) combined with D-dimer in the diagnosis of emergency pulmonary embolism. 108 patients with suspected pulmonary embolism were selected, the CTPA and D-dimer were examined, the level of serum D-dimer in patients with pulmonary embolism was significantly higher than that in patients without pulmonary embolism (P<0.05). The area under the ROC curve of D-dimer in predicting pulmonary embolism was 0.921 (P<0.05). The detection rate of CTPA pulmonary embolism in patients with D-dimer ≥ 2.50 μg/mL was significantly higher than that in patients with D-dimer < 2.50 μg/mL (P<0.05). In the indirect signs of CPTA, the proportion of irregular consolidation, atelectasis and inferior vena cava reflux of pulmonary embolism patients were higher than those of non pulmonary embolism patients (P<0.05), D-dimer was positively correlated with CT pulmonary embolism index (CTI%) (r=0.684, P<0.05). CTPA combined with D-dimer detection has good application value in the diagnosis of emergency pulmonary embolism, especially in patients with D-dimer level ≥ 2.50 μg/mL, the detection rate of CTPA pulmonary embolism is high.

Key words: CT pulmonary angiography, D-dimer, emergency pulmonary embolism, diagnostic value

黎勇, 周毅, 杨弟春, 段龙玉. 肺CTPA联合D-二聚体检测对急诊肺栓塞的诊断研究[J]. 影像科学与光化学, 2022, 40(5): 1221-1225.

LI Yong, ZHOU Yi, YANG Dichun, DUAN Longyu. Study of Pulmonary CTPA Combined with D-dimer in the Diagnosis of Emergency Pulmonary Embolism[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1221-1225.

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