使用D-二聚合物/pCO2比率在D-二聚合物阳性急诊室患者的CT前风险分层:诊断准确性研究
Cem Yıldırım1, Ahmet Aykut2, Ertuğ Günsoy2
1Emergency Department, SBU. Van Education and Research Hospital, Van, Turkey. yildirimcem06@gmail.com.
BMC emergency medicine
|November 18, 2025
概括
D-二聚合物/pCO2比率有助于肺栓塞 (PE) 风险分层为急诊室的患者与积极的D-二聚合物结果. 这个比率可以帮助为成像决策提供信息,但不是一个独立的诊断测试.
科学领域:
- 紧急医疗 紧急医疗
- 诊断成像 诊断成像 诊断成像
- 临床化学 临床化学
背景情况:
- 肺栓塞 (PE) 诊断依赖于风险分层,D-二次体检测是常见的初步步骤.
- 对于PE风险分层的D-二聚合物/pCO2比率的诊断实用性仍然不完全理解.
- 这项研究调查了D-二次体/pCO2比率在急诊室 (ED) 患者的表现,这些患者的D-二次体年龄调整结果为阳性.
研究的目的:
- 为了评估D-二分体/pCO2比率的诊断性能,在急诊室的患者中,年龄调整后的D-二分体结果呈阳性.
- 评估该比率有助于风险分层的能力,并为计算机断层扫描肺血管扫描 (CTPA) 的决策提供信息.
- 确定PE检测和排除中央PE的最佳值.
主要方法:
- 698名成年患者的追溯诊断准确性研究,年龄调整为正的D-二次体,静脉血液气体 (VBG) pCO2和CTPA.
- 计算D-二聚合物/pCO2比率和接收器运行特征 (ROC) 分析.
- 评估最佳和探索性值,引导验证,亚组AUC比较和决策曲线分析 (DCA).
主要成果:
- 肺栓塞 (PE) 在12.9%的患者中得到证实.
- D-二聚合物/pCO2的比率显示出良好的区别 (AUC:0.811).
- 最佳切断点 (44.91) 产生了82.2%的灵敏度和96.4%的负预测值 (NPV). 较低和较高的门分别显示了PE排除和中央PE排除的潜力,具有良好的特异性和低的虚假负率.
结论:
- D-二聚合物/pCO2比率作为D-二聚合物阳性ED患者接受CTPA的辅助成像选指标.
- 该比率可以帮助在这个特定的患者群体中改进成像工作流程.
- 这些发现不适用于D-二分体阴性患者或具有非常高预测概率的患者.
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