摘要
Abstract
Objective To investigate the value of Padua prediction score combined with D-dimer testing in the identification of venous thromboembolism (VTE) in medical inpatients with type 2 diabetes mellitus (T2DM).Methods We did a review of the data of 305 T2DM patients who were suspected with VTE [176 (VTE group) were diagnosed confirmedly with VTE later while 129 (non-VTE group) were not] and admitted to Department of Endocrinology,the 474th Hospital of Chinese People's Liberation Army from January 2013 to March 2016.The receiver operating characteristic (ROC) curve analysis was used to evaluate the probability of T2DM patients with VTE assessed by the Padua prediction score,D-dimer testing and the Padua prediction score combined with D-dimer testing.Results Compared with the non-VTE group,VTE group were older,and they had higher glycosylated hemoglobin levels,Padua prediction scores and plasma D-dimer levels,higher incidences of cardiovascular and cerebrovascular diseases,acute infection,chronic lung disease,malignant tumor,and higher proportion of patients with VTE history,but lower triacylglycerol levels (P ＜ 0.05).For the identification of VTE in medical inpatients with T2DM,the optimal cut-off point for Padua prediction score was 4,and it was 0.5 mg/L for D-dimer testing;the sensitivity,specificity,the Youden's index and area under the ROC curve (AUC) for Padua prediction score for assessing the VTE risk respectively were 53.41％,89.15％,0.426,and 0.713 [95％ CI (0.655,0.771)] when the cut-off point ≥4;and they were 84.12％,51.94％,0.361,0.683 [95％ CI (0.618,0.743)],respectively for D-dimer testing when the cut-off point ≥0.5 mg/L;and they were 93.75％,51.94％,0.457,0.801 [95％ CI (0.748,0.852)] respectively,for Padua prediction score ≥ 4 combined with D-dimer ≥ 0.5 mg/L testing.Padua prediction score combined with D-dimer testing had greater AUC than Padua prediction score did (Z =5.768,P ＜ 0.001) or than D-dimer testing did (Z =5.624,P ＜ 0.001),but the AUC did not differ significantly between Padua prediction score and D-dimer testing (Z =0.932,P ＞ 0.05).Conclusion The Padua prediction score combined with D-dimer testing is a simple but effective method for the risk assessment of VTE in medical inpatients with T2DM,which is conducive to the early identification of high-risk T2DM population clinically.关键词
糖尿病/静脉血栓栓塞/Padua评分/D-二聚体Key words
Diabetes mellitus/Venous thromboembolism/Padua prediction score/D-dimer分类
医药卫生
