Objective To explore the clinical application value of combined detection of D-dimer and Wells score in the diagnosis of venous thromboembolism (VTE).Methods For suspected venous thromboembolic disorders,including deep vein thrombosis(DVT) and pulmonary embolism (PE)patients,age,gender,major clinical symptoms and signs were recorded.According to Wells scale score,three groups were includied:low possibility group (0,＜2 points),moderate potential group (1-2 minutes,2-6 minutes) and highly likely group (3 or more points,＞ 6),at the same time for each patient to determine the D-dimer,screening out the diagnosis of patients with VTE,angiography with digital subtraction angiography (DSA) as a diagnostic gold standard was used,the accuracy of VTE was analyzed.Results Group with Wells score alone,low possibility of VTE diagnostic coincidence rate was 8％,false positive rate was 92％,moderate possibility of VTE coincidence rate was 30％,the high possibility of VTE coincidence rate 94.4％.Combined detection of D-dimer and Wells score,low possibility of VTE coincidence rate was 50％,false positive rate was 50％.Conclusion Relative to the Wells score alone,combined detection of D-dimer and Wells score can significantly decrease the false positive rate of low possibility group (P ＜ 0.05).%目的 探讨采用D-二聚体联合Wells评分检查,对静脉血栓栓塞性疾病(VTE)进行筛查的临床应用价值.方法 对于可疑静脉血栓栓塞性疾病(包括深静脉血栓及肺栓塞)患者均记录年龄、性别、主要的临床症状和体征,根据Wells量表进行评分,将下肢深静脉血栓形成(DVT)及肺栓塞(PE)分为低度可能性组(0分,＜2分),中度可能性组(1～2分,2～6分)以及高度可能性组(≥3分,＞6分),同时对每位患者进行D-二聚体的测定,筛查出拟诊VTE患者,以数掌减影血管造影(DSA)作为诊断金标准,对VTE的符合率进行统计并分析.结果 单独Wells评分,低度可能性组的VTE诊断符合率为8％,假阳性率为92％,中度低度可能性组VTE符合率为30％,高度可能性组VTE符合率94.4％;Wells评分联合D-二聚体检测,低度可能性组VTE符合率为50％,假阳性率为50％.结论 相对于单独Wells评分,Wells评分联合D-二聚体检测可以显著降低低度可能性组的假阳性率(P＜0.05).
展开▼
