摘要
目的探讨急性主动脉夹层(Acute aortic dissection,AAD)早期诊断中改良AAD风险评分的临床应用价值。方法选取嘉兴市第二医院急诊科2019年1月至2021年1月收治的主诉胸背部疼痛患者162例,收集所有患者一般资料、临床资料以及影像学资料,以是否确诊为AAD分为对照组(非AAD,n=120)和观察组(AAD,n=42),对比分析两组患者所有资料后,对差异有统计学意义的指标进行多因素logistic回归分析,再根据OR值的大小进行评分表的建立,通过受试者工作特征曲线(Receiver operating curve,ROC)对改良AAD风险评分预测情况进行评价。结果多因素logistic回归分析显示:男性、家族史、突发剧烈胸背部持续疼痛、双侧血压不对称、高血压、超声异常以及D-二聚体是诊断AAD的独立危险因素(统计值=7.84、6.96、7.04、11.38、7.12、8.15、15.07、9.11,均P<0.05);以总分5分为预测标准,获得预测AAD发生的特异度为84.94%,敏感度为95.43%。改良AAD风险评分受试者工作特征曲线下面积为0.909。结论改良AAD风险评分能够方便快捷地对AAD的发生进行预测,且预测价值较高。该研究具备显著创新性和科学性。
Objective To investigate the clinical value of modified acute aortic dissection risk score in the early diagnosis of acute aortic dissection(AAD).Methods The general,clinical,and imaging data of 162 patients who complained of chest and back pain who received treatment between January 2019 and January 2021 in the Department of Emergency,The Second Hospital of Jiaxing,China were collected for this study.The included patients were divided into control(non-AAD,n=120)and observation(AAD,n=42)groups according to whether they were diagnosed with AAD.The indexes with statistical significance between the two groups were analyzed using multivariate logistic regression analysis.A score table was established according to the size of OR value.The modified AAD risk score was predicted using the receiver operating curve.Results Multivariate logistic regression analysis showed that male sex,family history,sudden severe chest and back pain,bilateral blood pressure asymmetry,hypertension,abnormal ultrasound,and D-dimer level were independent risk factors for the diagnosis of AAD(statistical values=7.84,6.96,7.04,11.38,7.12,8.15,15.07,9.11,all P<0.05).Taking the total score of 5 as the prediction standard,the specificity and sensitivity in the prediction of the occurrence of AAD were 84.94%and 95.43%,respectively.The area under the receiver operating curve regarding the modified AAD risk score was 0.909.Conclusion The modified AAD risk score can be used to conveniently and quickly predict the occurrence of AAD and has a high predictive value.This study is highly innovative and scientific.
作者
陈伟
周新伟
徐杰
董方英
张明
Chen Wei;Zhou Xinwei;Xu Jie;Dong Fangying;Zhang Ming(Department of Emergency,The Second Hospital of Jiaxing,Jiaxing 314000,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2022年第1期18-22,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省嘉兴市公益性研究计划项目(2019AD32188)。
作者简介
通信作者:周新伟,Email:871896849@qq.com。
