| Objective: To explore the diagnostic significance of D-dimer(D-D)and fibrinogen(FIB)combined detection in patients with acute pulmonaryembolism(APE),to provide rapid and effective basis for the diagnosis and treatment of APE,ang also to provide help for the treatment of patients with APE in primary hospitals.Methods:1.In this study,retrospective analysis was used to analyze the data of 100 patients with acute pulmonary thromboemblism diagnosed in the emergency department and respiratory department of our hospital from March 2019 to March 2021 in the observation group and 100 patients community-acquired pneumonia who were admitted to the emergency department and respiratory department of our hospital during the same period in the control group.2.SPSS22.0 software was used to conduct correlation test on the general data of the two groups of patients,to identify the data with significant differences,and to conduct univariate Logistic regression analysis on the relevant indicators to determine the independent risk factors.Finally,Receiver Operating Characteristic curve was used.ROC Curve).The Area Under Curve(AUC)and its 95% confidence interval,sensitivity,specificity,Youden index and Cut-off value of related risk factors were analyzed to seek the best screening method for predicting acute pulmonary embolism disease.Results:1.The P values of age,gender,history of hypertension,history of diabetes and smoking history in the two groups were all greater than 0.05,there was no significant statistical difference in general data.2.The levels of D-dimer and fibrinogen in the observation group and the control group were compared,P values were all less than 0.05,the D-dimer level of the observation group and the control group were 1.665(0.518,3.780)ug/ m L and 0.120(0.070,0.230)ug/ m L,respectively,and the fibrinogen level was 2.501±1.071 g/L and 3.286±1.152 g/L,respectively.These results indicated that the D-dimer level was significantly increased and the fibrinogen level was significantly decreased in patients with acute pulmonary embolism.3.Univariate Logistic regression annlysis was performed on the indexes of D-dimer,fibrinogen,hypersensitive,C-reactive protein,alanine aminotransferasse,aspartate aminotransferase,low density lipoprotein,triglyceride and platelet in 2 groups.The P values of D-dimer,fibrinogen and platelet were all less than 0.05,is correlated with the occurrence of pulmonary embolism disease;P value of the remaining indicators were all greaterthan 0.05,no correlation.The OR value of D-dimer was 4.200,the 95%confidence interval was(2.402,7.342),and the regression coefficient was 1.435,indicating that the risk of acute pulmonary embolism increasedwith the increase of D-dimer level.The OR value of FIB was 0.407,the 95% confidence interval was(0.265,0.624),and the regression coefficient was-0.899,indicating that the risk of acute pulmonary embolism increased with the decrease of fibrinogen level.4.Combined with ROC curve,the AUC of D-dimer alone for predicting acute pulmonary embolism was 0.887,the sensitivity was 90%,the specificity was 76%,the Youden index was 0.660,and the cut-off value was 0.240.The AUC of fibrinogen alone was 0.714,the sensitivity was 67%,the specificity was 75%,the Youden index was 0.420,and the Cut-off value was 2.420.The sensitivity,specificity and Youden index were 87%,84% and 0.710 respectively for predicting acute pulmonary embolism.Conclusions:The combination of D-dimer and fibrinnogen has better diagnostic significance for acute pulmonary embolism than that of the two alone. |
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