Application of fibrinogen and D-dimer in the diagnosis of acute pulmonary embolism / 中国基层医药

ABSTRACT

Objective To evaluate the clinical value of fibrinogen and D-dimer(D-D)in the diagnosis of patients with acute pulmonary embolism.Methods A retrospective study was conducted.74 patients with acute pulmonary embolism were retrospectively analyzed.The general clinical data were gathered,and the patients were divided into high-risk group(n=20),moderate-risk group(n=32),and low-risk group(n=22)according to the 2008 ESC Guidelines on the diagnosis and management of acute pulmonary embolism.25 patients with physical examination were randomly recruited as control group.The plasma levels of fibrinogen and D-D were detected and compared between these groups.Receiver operating characteristic curve(ROC)was used to evaluate diagnostic biomarker performance.Results In acute pulmonary embolism patients,with the risk degree increased,the level of fibrinogen decreased[(4.20±0.82)g/L,(4.16±0.83)g/L,(3.62±0.74)g/L,(2.83±0.62)g/L](compared with control group,P=0.183,moderate-risk group,P=0.046,high-risk group,P=0.033;compared with low-risk group,moderate-risk group,P=0.041,high-risk group,P=0.037;compared with moderate-risk group,P=0.044),and the level of D-D increased[(1 845.20±3 939.56)μg/L,(4 405.27±2 356.68)μg/L,(4 360.63±2 675.40)μg/L,(16 817.00±6 878.66)μg/L](compared with the control group,low-risk group,P=0.392,moderate-risk group,P=0.042,high-risk group,P=0.027;compared with low-risk group,P=0.136,P=0.016;compared with moderate-risk group,P=0.035).The ROC curve showed that the AUC of D-D in each group were 0.865,0.834 and 0.974,respectively.AUC of FIB were 0.459,0.253 and 0.277,respectively,which were below or even significantly lower than predicted line area.Conclusion The performance of fibrinogen in the diagnosis of acute pulmonary embolism and the classification of the risk degree is very low.