Objective To investigate the application value of detecting the plasma D-dimer level and artery blood gas analysis in the diagnosis of sub-massive pulmonary embolism.Methods 27 cases with diagnosed pulmonary embolism from 2010 to 2015 were chosen and all the patients received the detection of D-dimer and artery blood gas analysis.Retrospectively analyzed the clinical symptoms and the results of D-dimer and artery blood gas analysis.Results Coughs, dyspnea and pleuritic chest pain were the three commonest clinical symptoms, which accounting for 51.85%,44.44% and 33.33%.4 respectively.Four out of the 27 cases of patients had normal plasma D-dimer,accounting for 14.81%, and 23 cases with increasing D-dimer which accounted for 85.19%.The blood gas analysis showed that 6 cases had normal PaO2 , accounting for 22.22%, and 21 cases with reducing PaO2 , accounting for 77.78%.5 cases had normal PaCO2 , accounting for 18.52%, and 22 cases with reducing PaCO2 , accounting for 81.48%.4 cases with normal P(A-a)O2 accounting for 14.81%, and 23 cases with increasing P (A -a) O2 accounting for 85.19%.Taking indices of D-dimer and blood gas analysis into account, the increased sensitivity of PaO2 or PaCO2 or P(A-a)O2 could rise to 100%.Conclusions The D-dimer positive plus blood gas analysis boast great applied prospect for the diagnosis of sub-massive pulmonary embolism.D-dimer negative combined with normality of artery blood gas indices can served as important basis for excluding sub-massive pulmonary embolism.%目的探讨血浆 D－二聚体联合动脉血气分析在次大面积肺栓塞诊断中的价值。方法选择2010至2015年西安交通大学医学院附属西安市中心医院确诊次大面积肺栓塞患者31例，其中27例确诊患者全部行 D－二聚体及血气分析检测，回顾性分析其临床症状、D－二聚体及动脉血气分析结果。结果咳嗽、呼吸困难、胸膜炎性胸痛是最常见的三大临床症状，分别占51．85％、44．44％、33．33％。27例患者中血浆 D－二聚体正常者4例，占14．81％，升高者23例，占85．19％。血气分析结果表明动脉血氧分压（PaO2）正常者6例，占22．22％，降低者21例，占77．78％；动脉二氧化碳分压（PaCO2）正常者5人，占18．52％，降低者22人，占81．48％；P（A－a）O2正常者4例，占14．81％，升高者23例，占85．19％；D－二聚体与血气分析各指标综合考虑时，D－二聚体阳性伴有 PaO2降低或 PaCO2降低或 P（A－a）O2升高的敏感度可升至100％。结论血浆 D－二聚体阳性联合动脉血气分析对次大面积肺栓塞患者具有较高的诊断价值；血浆 D－二聚体阴性联合动脉血气分析各项指标均正常可作为排除次大面积肺栓塞的重要依据。
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