【摘要】 目的:探讨血浆D-二聚体水平联合Wells评分对慢性心力衰竭(CHF)合并下肢深静脉血栓(LDVT)的诊断价值。方法:回顾性分析100例CHF疑似合并LDVT患者的临床资料,分别应用血浆D-二聚体、Wells评分及二者结合的方法对患者进行诊断,同时与彩色多普勒的诊断结果进行比较分析。结果:血浆D-二聚体对LDVT诊断的灵敏度为84.71%、特异度为40.00%、正确度为78.00%,与彩色多普勒超声行一致性检验,两种方法诊断LDVT的一致性较差(Kappa值=0.223)。Wells评分对LDVT诊断的灵敏度为94.12%、特异度为60.00%、正确度为89.00%,与彩色多普勒超声行一致性检验,两种方法诊断LDVT的一致性一般(Kappa值=0.556)。血浆D-二聚体联合Wells评分对LDVT诊断的灵敏度为98.82%、特异度为73.33%、正确度为95.00%,与彩色多普勒超声行一致性检验,两种方法诊断LDVT的一致性较好(Kappa值=0.786)。结论:血浆D-二聚体水平联合Wells评分诊断CHF合并LDVT具有更高的灵敏度和准确性,且简便、快捷,具有临床推广价值。更多还原

【Abstract】 Objective: To investigate the diagnostic value of plasma D-dimmer level combined with Wells score for chronic heart failure(CHF) suspected with lower limb deep venous thrombosis(LDVT). Methods: The clinical data of 100 CHF patients suspected with LDVT were retrospectively analyzed. The patients were diagnosed respectively by plasma D-dimmer level, Wells score and combination of the two methods; The results were compared with the diagnostic results of color Doppler at the same time. Results: The sensitivity, specificity and accuracy of D-dimmer for diagnosing LDVT was 84.71%, 40.00% and 78.00% respectively. The consistency between D-dimmer and color Doppler was poor(Kappa=0.223). The sensitivity, specificity and accuracy of Wells score for diagnosing LDVT was 94.12%, 60.00% and 89.00% respectively. The consistency between Wells score and color Doppler was general(Kappa=0.556). The sensitivity, specificity and accuracy of D-dimmer combined with Wells score for diagnosing LDVT was 98.82%, 73.33% and 95.00% respectively. The consistency between combination of above two methods and color Doppler was better(Kappa=0.786). Conclusions: D-dimmer combined with Wells score has higher sensitivity and accuracy for diagnosing CHF suspected with LDVT, which is simple and rapid, and has the value of clinical promotion.更多还原