Department of Ultrasound, The Affiliated Hospital of Yunnan University, The Second People's Hospital of Yunnan Province, Kunming, China.
J Coll Physicians Surg Pak. 2024 Sep;34(9):1127-1129. doi: 10.29271/jcpsp.2024.09.1127.
The clinical risk factors and risk of developing pulmonary embolism (PE) in patients with acute isolated distal deep venous thrombosis (IDDVT) were assessed using single complete-duplex ultrasound (CDUS) imaging to reduce over-testing and over-treatment. This observational study was conducted from January 2020 to December 2022. Retrospective analysis was performed on CT pulmonary angiography (CTPA), blood coagulation markers, myocardial injury markers, blood gas analysis, and CDUS imaging of the lower extremity blood vessels of 146 patients with newly diagnosed IDDVT. Binary logistic regression was used to evaluate the relationship between these indicators and PE. After stepwise regression analysis, the predictors included in the regression model were D-dimer (DD), the sum of the thrombus length, and the maximum value of the thrombus width, with odds ratios (ORs) of 1.307 (p <0.001), 1.018 (p = 0.005), and 1.613 (p = 0.018), respectively. The combined prediction model achieved an area under the receiver operating characteristic curve (AUC) of 0.832 [95% confidence interval (CI): 0.761, 0.902]. By balancing the sensitivity and specificity of DD, combined single CDUS improves the predictive value for PE in patients with IDDVT. Key Words: Venous thrombosis, Pulmonary embolism, Ultrasonography, D-dimer, Diagnosis.
临床危险因素和急性孤立性远端深静脉血栓形成（IDDVT）患者发生肺栓塞（PE）的风险，采用单次完全双功能超声（CDUS）成像来减少过度检查和过度治疗。本观察性研究于 2020 年 1 月至 2022 年 12 月进行。对 146 例新发 IDDVT 患者的 CT 肺动脉造影（CTPA）、凝血标志物、心肌损伤标志物、血气分析和下肢血管 CDUS 影像进行回顾性分析。采用二项逻辑回归评估这些指标与 PE 之间的关系。经过逐步回归分析，纳入回归模型的预测因子包括 D-二聚体（DD）、血栓长度总和和血栓宽度最大值，比值比（ORs）分别为 1.307（p<0.001）、1.018（p=0.005）和 1.613（p=0.018）。联合预测模型的受试者工作特征曲线下面积（AUC）为 0.832[95%置信区间（CI）：0.761，0.902]。通过平衡 DD 的敏感性和特异性，联合单次 CDUS 提高了 IDDVT 患者对 PE 的预测价值。关键词：静脉血栓形成；肺栓塞；超声检查；D-二聚体；诊断。
