Applications of computed tomography and ischemic modified albumin and D-D Levels in disease assessment of patients with acute pulmonary embolism / 中国医师杂志

ABSTRACT

Objective To investigate the clinical application values of computed tomography (CT),ischemic modified albumin (IMA) and D-dimer (D-D) levels in the disease assessment of patients with acute pulmonary embolism (APE).Methods From June 2015 to June 2018,100 suspected APE patients in our hospital were selected as the study subjects,after the CT " gold standard" inspection,the 80 patients diagnosed with APE were as APE group,including 38 cases in high-risk group and 42 cases in low-risk group20 non APE cases and 60 healthy volunteers at the same time were selected as control group.The serum IMA level was detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA),and the plasma D-D level was detected by immunoturbidimetry.Receiver operating characteristc (ROC) curve was used to analyze the diagnostic values of IMA and D-D for APE disease.Results The levels of IMA and D-D in APE group were significantly higher than those in non APE group and control group (P ＜ 0.05);the levels of IMA and D-D in non APE group were significantly higher than those in control group (P ＜ 0.05),while those in high-risk group were significantly higher than those in low-risk group (P ＜ 0.05);CT examination after admission was as the gold standard for diagnosing APE disease;ROC curve showed that,the area under curve (AUC) of D-D and IMA in diagnosing APE was 0.875 and 0.763,respectively,with corresponding sensitivity 90.01％ and 93.87％,specificity 52.21％ and 95.65％ respectively;the AUC of IMA combined D-D level in diagnosing APE was 0.834,the sensitivity was 95.87％,and the specificity was 78.69％;the AUC of D-D and IMA in diagnosing high-risk APE was 0.950 and 0.914,respectively,with the corresponding sensitivity 97.21％ and 93.98％,specificity 31.58％ and 76.98％,respectively.The AUC of IMA combined D-D level in diagnosing high-risk APE was 0.958,with sensitivity 96.39％,specificity 76.87％.Compared with CT results,in the 80 patients diagnosed with APE,there were 4 patients with negative IMA and 6 patients with negative D-D,and the control group samples test showed negative IMA and D-D levels were all negative.The consistency of CT combine with D-D (Kappa =0.734,P =0.000),and CT combine with IMA (Kappa =0.819,P =0.000) were good.Conclusions According to the results of CT examination,IMA combined with D-D level has a good sensitivity and specificity in the diagnosis of APE,which can effectively improve the diagnostic rate of APE diseases,and provide an important basis for clinical rapid and reliable detection and treatment of APE diseases.