血浆D-二聚体、纤维蛋白原联合检测在急性肺栓塞中诊断价值.docVIP

血浆D-二聚体、纤维蛋白原联合检测在急性肺栓塞中诊断价值[摘要] 目的 探讨血浆D-二聚体（D-D）、纤维蛋白原 （Fg）联合检测在急性肺栓塞中的诊断价值。方法 血浆D-二聚体和Fg用STAGOSTA Compact全自动血凝仪检测，分别检测40例急性肺栓塞（APE）和40例正常健康人中的D-二聚体和Fg的水平，所有数据用SPSS11.5软件包进行分析。结果 急性肺栓塞患者血浆D-二聚体和Fg水平均显著高于正常组，差异有统计学意义（P＜0.05）。D-二聚体和Fg单独检测APE的灵敏度分别为80.0%、71.6%，特异度分别为41.2%、33.1%，两者联合检测APE的灵敏度为95.0%、特异度为56.3%。结论 血浆D-二聚体、Fg在APE诊断中具有重要临床意义，联合检测血浆中D-二聚体、Fg的水平有利于提高急性肺栓塞的诊断率。 [关键词] D-二聚体；纤维蛋白原；急性肺栓塞 [中图分类号] R563.5 [文献标识码] B [文章编号] 1673-9701（2011）35-64-02 Study on the Value of Combined Detection of D-D，Fg in APE YE Junqin HE Yuejing HUANG Huiping The Clinical Laboratory of Hospital of Shilong Boai Hospital，Dongguan 523325，China [Abstract] Objective To evaluate the value of combined analysis of D-D，Fg in the APE. Methods Plasma level of D-D and Fg in each patient was determined with STAGOSTA Compact，plasma levels of D-D and Fg were collect from 40 cases with APE，40 cases helthy volunteers. Statistical analysis was performed by using SPSS11.5. Results The concentration of D-D and cTnI in APE group were higher than those helthy volunteers group（P＜0.05）.The sensitivity rates of D-D and Fg in APE were 80.0%，71.6%，respectively，the specific rates were 41.2%，33.1%，respectively.In combined assay of D-D and Fg，the sensitivity rate was 95.0%，the specificity rate was 56.3% comparing with the single assay，combined analysis had much higher diagnostic sensitivity. Conclusion The assay of D-D and Fg is significant in diagnosis of APE. In Combined assay of D-D and Fg can improve the rate of early APE. [Key words] D-D；Fg；APE 肺栓塞（pulmonary embolism，PE）是临床上较常见的疾病之一，它是由于各种栓子阻塞肺动脉而引发的肺动脉循环障碍的一种疾病[1]。由于该病症状多种多样，且缺乏特异性，故较易出现漏诊和误诊。本文就我院2010年1月～2011年5月收治的APE患者血清中Fg、D -二聚体的变化，并与对照组比较，旨在探讨两者联合检测对评价APE的诊断意义，现报道如下。 1 对象与方法 1.1检测对象 40例急性肺栓塞病人均为我院2010年1月～2011年5月住院病例，根据临床症状和螺旋CT确诊，其中男28例，女12例，年龄33～70岁，平均48.1岁。排除有急性心肌梗死病史、冠脉成形术史、旁路移植术史、慢性肾功能衰竭史、中重度阻塞性肺病或合并急性感染。选取40例健康人作为对照组，年龄30～69岁，平均47.3岁，均经检查排除肺栓塞。 1.2 方法 所有病人采集完整病史及详细体检，所有患者均空腹8h，抽取上肢外周静脉血6mL，分离标本，入院24h内完成检测。D-二聚体和F