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Wells评分、修正Geneva评分联合D-二聚体对慢阻肺急性加重合并肺栓塞风险的预测价值

Zhonghua yi xue za zhi(2019)

Department of Respiratory and Critical Care Medicine

Cited 14|Views74
Abstract
目的 评估Wells评分、修正Geneva评分联合D-二聚体对慢性阻塞性肺疾病(简称慢阻肺)急性加重(AECOPD)合并肺栓塞风险的预测价值.方法 研究对象为郑州大学第一附属医院2013年3月1日至2015年12月31日因AECOPD入院且均行CT肺动脉造影的234例患者.收集患者的临床资料,根据CT肺动脉造影结果分为AECOPD合并肺栓塞组和单纯AECOPD组.对所有患者行Wells评分评分和修正Geneva评分,制作受试者工作特征(ROC)曲线,应用Z检验对ROC曲线下面积(AUC)进行比较,评价其预测价值.结果 234例AECOPD患者中合并肺栓塞组32例(13.7%),单纯AECOPD组202例(86.3%).Wells评分、修正Geneva评分、D-二聚体、Wells评分+D-二聚体、修正Geneva评分+D-二聚体的AUC分别为0.869(95% CI:0.789 ~0.949)、0.710(95%CI:0.588 ~0.832)、0.866(95% CI:0.790 ~0.941)、0.926(95% CI:0.874~0.977)、0.855(95% CI:0.751 ~0.959).Wells评分、D-二聚体的AUC均显著大于修正Geneva评分(Z=2.14、2.12,均P<0.05);Wells评分+D-二聚体的AUC显著大于修正Geneva评分+D-二聚体(Z=2.73,P<0.05).结论 Wells评分+D-二聚体对AECOPD合并肺栓塞的预测价值比修正Geneva评分+D-二聚体高.
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Key words
Chronic Obstructive Pulmonary Disease,D-dimer,Pulmonary Embolism,Revised Geneva score,Wells score
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