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张 桃 高兴法 王利东▲.急性肺栓塞患者同型半胱氨酸、D-二聚体水平与CT肺动脉阻塞指数的关系[J].中国现代医生,2021,59(4):9-12+17
急性肺栓塞患者同型半胱氨酸、D-二聚体水平与CT肺动脉阻塞指数的关系
Relation between homocysteine and D-dimer levels and CT pulmonary artery occlusion index in patients with acute pulmonary embolism
  
DOI:
中文关键词:  急性肺栓塞  同型半胱氨酸  D-二聚体  CT 肺动脉阻塞指数
英文关键词:Acute pulmonary embolism  Homocysteine  D-dimer  CT pulmonary artery occlusion index
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作者单位
张 桃 高兴法 王利东▲ 内蒙古自治区国际蒙医医院影像中心内蒙古呼和浩特 010020 
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中文摘要:
      目的分析急性肺栓塞(APE)患者同型半胱氨酸(Hcy)、D-二聚体(DD)水平与CT 肺动脉阻塞指数(CTPAOI)的相关性。方法 选取2016 年1 月至2019 年12 月经CT 肺动脉成像确诊的42 例APE 患者作为观察组,同期在我院行CT 肺动脉成像检查的无肺栓塞患者30 例作为对照组;比较两组Hcy、DD 水平;另将观察组患者按CTPAOI 再分组,比较不同程度APE 患者Hcy、DD 水平;Spearman 相关性分析Hcy、DD 与CTPAOI 的相关性。结果 观察组Hcy、DD 均高于对照组(P<0.05);42 例APE 患者根据CTPAOI 分为轻度12 例,中度17 例,重度13 例,重度组、中度组患者Hcy 值与轻度组比较,差异有统计学意义(P<0.05),三组患者的DD 值比较,差异有统计学意义(P<0.05);经Spearman 相关性分析,Hcy、DD 与CTPAOI、Hcy 与DD 均呈显著正相关(P<0.05);Hcy 检测APE 的ROC 曲线显示曲线下面积为0.848,95%CI 为0.759~0.936,最佳截断点为14.33 μmol/L,相应敏感度、特异度分别为69%、93%。DD 检测APE 的ROC 曲线显示曲线下面积为0.967,95%CI 为0.921~1.000,最佳截断点为0.88 mg/L,相应敏感度、特异度分别为95%、93%。结论Hcy、DD 水平或可与CTPAOI 同作为反映APE 患者疾病严重程度的生物学指标,值得临床重视。
英文摘要:
      Objective To analyze the correlation between homocysteine(Hcy) and D-dimer(DD) levels and CT pulmonary artery occlusion index (CTPAOI) in patients with acute pulmonary embolism (APE).Methods Patients with APE diagnosed by CT pulmonary artery imaging in our hospital from January 2016 to December 2019 as the research subjects were taken into the observation group(n=42),while patients without pulmonary embolism diagnosed by CT pulmonary artery imaging in our hospital during the same period were taken into the control group(n=30).The levels of Hcy and DD were compared between the two groups.In addition,the patients in the observation group were further grouped according to CTPAOI to compare the levels of Hcy and DD in patients with APE to different degrees.Spearman correlation analysis was used to analyze the correlation between Hcy,DD and CTPAOI.Results The Hcy and DD levels in the observation group were higher than those in the control group(P<0.05).According to CTPAOI,42 patients with APE were divided into mild cases(n=12),moderate cases(n=17),and severe cases(n=13).The difference of Hcy values between the moderate to severe patients and the mild group was statistically significant(P<0.05),and the difference of DD value among the three groups was statistically significant.In Spearman′s correlation analysis,there was a significant positive correlation between Hcy and DD,and among CTPAOI,Hcy and DD(P<0.05).The ROC curve of APE detected by Hcy showed that the area under the curve was 0.848,the 95% CI was 0.759-0.936,the optimal cutoff point was 14.33 μmol/L,and the corresponding sensitivity and specificity were 69% and 93%,respectively.The ROC curve of APE for DD detection showed that the area under the curve was 0.967,the 95%CI was 0.921-1.000,the optimal cutoff point was 0.88 mg/L,and the corresponding sensitivity and specificity were 95% and 93%,respectively.Conclusion The levels of Hcy and DD,or their equivalents with CTPAOI,can be used as biological indexes reflecting the disease severity in patients with APE,so they deserve clinical attention.
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