Pulmoner emboli şüpheli hastalarda CRP, d-dimer, d-dimer
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Dosyalar
Tarih
2020
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Pulmoner emboli ön tanısı ile toraks bilgisayarlı tomografi anjiografi ve/veya akciğer sintigrafisi çekilen hastaların D-dimer, CRP, D-dimer/CRP parametreleri incelenerek PE için tanısal değerlerinin araştırılması planlandı. Böylece gereksiz to-raks BT Anjiografi çekilmesinin azaltılabileceği düşünüldü. Gereç ve yöntem: Çalışmamızda Hatay Mustafa Kemal Üniversitesi Tayfur Ata Sök-men Tıp Fakültesi Sağlık Araştırma ve Uygulama Hastanesi Göğüs Hastalıkları Polik-liniği ve Acil servise başvuran ve pulmoner emboli ön tanısı ile toraks BT Anjiografi ve/veya akciğer sintigrafisi çekilen, eş zamanlı olarak D–dimer ve CRP tetkikleri ça-lışılan hastalar retrospektif olarak değerlendirildi. Wells skoru ile D-dimer, D-di-mer/CRP ve CRP kombinasyonunun pulmoner emboli ön tanısında etkinliği ve güve-nirliliği değerlendirildi. Bulgular: Çalışmamıza pulmoner emboli şüpheli 79 hasta dahil edildi. Pulmoner em-boli tanısı objektif testlerle kesinleştirilen hastalar ile pulmoner emboli ekarte edilen hastaların karşılaştırılan bazı testlerinin sonuçları; WELLS skoru PTE tanı koymadaki özgüllüğü %100, duyarlılığı %41.3, D-dimer duyarlılık % 91.3, özgüllük %27.27 CRP duyarlılığı %84.7 özgüllüğü %42.4 bulundu. CRP oranları PTE görülen has-talarda anlamlı derecede yüksekti. Fakat D-dimer /CRP oranı tanı koymadaki özgüllüğü %56, duyarlılığı %45, bulundu. Hastaların D-dimer/CRP değerlerinin PTE tanısı koymasında duyarlılık ve özgüllüğün bir arada veren ROC eğrisi analizi yapıldı. Cutt off D-dimer/CRP oranı değeri = 119.5 idi. Sonuç: Çalışmamızda D-dimer ve CRP oranları PTE görülen hastalarda anlamlı oranda yüksek bulundu fakat D-dimer / CRP oranları PTE ön tanısındaki duyarlılık ve özgüllüğü tanı koymada daha az değerli bulundu.
Aim: It was planned to investigate the diagnostic values for PE by examining D-dimer, CRP, D dimer/CRP parameters of patients who underwent thorax CT angiography and/or lung scintigraphy with pre-diagnosis of pulmonary embolism. So it was thought that unnecessary thoracic CT Angiography could be reduced. Methods: In our study, patients who applied to the Chest Diseases Outpatient Clinic of Hatay Mustafa Kemal University Tayfur Ata Sökmen Medical Faculty Health Re-search and Application Hospital and who underwent thoracic CT Angiography and/or lung scintigraphy with the prediagnosis of pulmonary embolism and simultaneously studied D-dimer and crp examinations were evaluated. The efficiency and reliability of the Wells score and the combination of D-dimer, D-dimer/CRP and CRP in the pre-diagnosis of pulmonary embolism were evaluated. Results: 79 patients with suspected pulmonary embolism were included. Results of tests comparing patients whose pulmonary embolism diagnosis was confirmed by ob-jective tests and patients whose pulmonary embolism diagnosis was excepted; WELLS score, specificity of PTE diagnosis was found to be 100%, sensitivity of 41.3%, D-dimer sensitivity of 91.3%, specificity of 27.27%, CRP sensitivity of 84.7%, specific-ity of 42.4%. CRP rates were higher in patients with PTE. However, D-dimer/CRP ratio was found to have a diagnostic specificity of 56% and a sensitivity of 45%. ROC curve analysis, which gives the patients sensitivity and specificity together, was per-formed for the diagnosis of PTE of D-dimer/CRP values. Cutt off D-Dimer/Crp ratio value = 119.5. Conclusion: In our study, D-dimer and CRP ratios were found to be significantly higher in patients with PTE, but D-dimer/CRP ratios were found to be less valuable in the diagnosis of PTE sensitivity and specificity.
Aim: It was planned to investigate the diagnostic values for PE by examining D-dimer, CRP, D dimer/CRP parameters of patients who underwent thorax CT angiography and/or lung scintigraphy with pre-diagnosis of pulmonary embolism. So it was thought that unnecessary thoracic CT Angiography could be reduced. Methods: In our study, patients who applied to the Chest Diseases Outpatient Clinic of Hatay Mustafa Kemal University Tayfur Ata Sökmen Medical Faculty Health Re-search and Application Hospital and who underwent thoracic CT Angiography and/or lung scintigraphy with the prediagnosis of pulmonary embolism and simultaneously studied D-dimer and crp examinations were evaluated. The efficiency and reliability of the Wells score and the combination of D-dimer, D-dimer/CRP and CRP in the pre-diagnosis of pulmonary embolism were evaluated. Results: 79 patients with suspected pulmonary embolism were included. Results of tests comparing patients whose pulmonary embolism diagnosis was confirmed by ob-jective tests and patients whose pulmonary embolism diagnosis was excepted; WELLS score, specificity of PTE diagnosis was found to be 100%, sensitivity of 41.3%, D-dimer sensitivity of 91.3%, specificity of 27.27%, CRP sensitivity of 84.7%, specific-ity of 42.4%. CRP rates were higher in patients with PTE. However, D-dimer/CRP ratio was found to have a diagnostic specificity of 56% and a sensitivity of 45%. ROC curve analysis, which gives the patients sensitivity and specificity together, was per-formed for the diagnosis of PTE of D-dimer/CRP values. Cutt off D-Dimer/Crp ratio value = 119.5. Conclusion: In our study, D-dimer and CRP ratios were found to be significantly higher in patients with PTE, but D-dimer/CRP ratios were found to be less valuable in the diagnosis of PTE sensitivity and specificity.
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Anahtar Kelimeler
Göğüs Hastalıkları, Chest Diseases, pulmoner emboli, D-dimer, CRP, pulmonary embolism, D-dimer, CRP
