【摘要】 目的比较不同辅助检查在肺栓塞(PulmonaryEmbolism,PE)患者的应用价值。方法回顾诊断和非诊断肺栓塞的患者D二聚体、下肢静脉超声(lowerextremityDopplerultrasoundDUS),胸部螺旋CT(chestspiralComputerTomographyCT)的结果,找出合适敏感度和特异度的方法。结果D-二聚体是筛除肺栓塞的良好指标,其医学决定性水平宜在500μg/L;临床概率低的患者总体D-二聚体偏高;确诊肺栓塞的患者检查敏感度分别为D-二聚体80%、螺旋CT90%、下肢静脉超声60%;对于低临床概率患者,D-二聚体阴性可以有效除外肺栓塞,漏诊率7.7%。结论D-二聚体在医学决定性水平为500μg/L时,是一项高敏感度和阴性预计值的指标,尤其适合临床低概率患者的筛除,配合螺旋CT,可以很好地辅助肺栓塞的诊断。更多还原

【Abstract】 Objective Compare the efficiency of different assistant clinical tests used in pulmonary embolism(PE). Methods To value the D-dimer, lower extremity Doppler ultrasound(DUS), chest spiral computer tomography(CT) results of PE and non-PE patients, find good sensitivity and specificity tests. Results D-dimer is a good clinical test for PE, its cut-off value is 500 μg/L . The low clinical probability patients have higer D-dimer. The PE patients have positive rates of D-dimer, CT, DUS 80%, 90%, 60%, respectively. D-dimer is more efficient to rule out PE in lower clinical probability patients, the failure rate is 7.7 %. Conclusion D-dimer is a high sensitivity and specificity test in the assistant diagnosis of PE, especially for lower clinical probability patients; when combined with CT, it can be a good assistant index of PE diagnosis.更多还原