根据年龄校正的 D-二聚体临界值标准对急性肺栓塞的诊断价值.

Objective: To explore the diagnostic value of age-adjusted d-dimer cut-off for the acute pulmonary embolism(APE). Methods: Computed Tomography Pulmonary Angiography (CTPA) was performed for the diagnosis of 367 cases of suspected APE, and enzyme-linked immunosorbent assay (ELISA) was used to detect D-dimer concentration. The sensitivity, specificity, accuracy, negative prediction value and positive predictive value between age-adjusted D-dimer cut-off [(age× 10) μg/L] and traditional cut-off (500μg/L) was compared. Results: 367 suspected APE patients, 64 cases was confirmed with the detection rate of 17.4％. The concentration of D-dimer in APE patients was (2108.5± 335.9) μg/L, was significantly higher than(486.8± 65.2) μg/L in non APE patients (t=27.61, P＜0.05). The concentration of D-dimer in APE patients more than 60 year-old was (2931.8± 509.4) μg/L, was significantly higher than (1806.1± 319.6) μg/L in patients less than 60 year-old (t=1 0.77, P＜0.05). The specificity, coincidence rate, positive predictive value and area under the curve (AUC) of age-adjusted D-dimer cut-off in the diagnosis of APE were significantly increased than those of traditional D-dimer cut-off (P＜0.05). While there was no significant difference on sensitivity, negative predictive value between two cut-offs(P＞0.05). Conclusions: The D-dimer concentration was increased with the increase of age, age-adjusted D-dimer cut-off could improve the efficiency of the diagnosis of APE, reduce the missed diagnosis, it was especially suitable for the patients more than 50 years old. [ABSTRACT FROM AUTHOR]