目的：探讨D-二聚体(D-dimer，D-D)联合纤维蛋白原(fibrinogen，FIB)对2型糖尿病内科住院患者急性肺栓塞的诊断价值。方法：选择2013年1月至2016年3月经CT肺动脉造影确诊急性肺栓塞的2型糖尿病内科住院患者及同期排除肺栓塞的2型糖尿病患者各80例，检测D-D及FIB水平。结果：在2型糖尿病急性肺栓塞患者中，D-D及FIB水平明显高于对照组。D-D和FIB单独检测诊断急性肺栓塞时的灵敏度、特异度、约登指数及ROC曲线下面积分别为：72.5%，42.5%；62.5%，91.25%；0.35，0.338；0.675(95%CI：0.597~0.747)，0.669(95%CI：0.590~0.741)；两者联合检测诊断急性肺栓塞时灵敏度为85.0%，特异度为60.0%，约登指数为0.45，工作特征曲线(receiver operator characteristic，ROC)下面积为0.773(95%CI：0.700~0.835)。D-D和FIB联合检测诊断急性肺栓塞时的ROC曲线下面积与单独检测D-D，FIB比较，差异有统计学意义(P<0.01)。结论：D-D联合FIB可作为2型糖尿病内科住院患者急性肺栓塞早期诊断时简单易行可靠的检测指标。
Diagnostic value of D-dimer and fibrinogen for type 2 diabetes mellitus with acute pulmonary embolism
Objective: To evaluate the diagnostic value of D-dimer (D-D) and fibrinogen (FIB) testing for diagnosis of type 2 diabetes mellitus with acute pulmonary embolism (APE). Methods: A total of 160 patients with type 2 diabetes in Department of Endocrinology in our hospital from January 2013 to March 2016 were selected and divided into APE group (n=80) and non-APE group (n=80) according to computed tomographic pulmonary angiography (CTPA). Plasma level of D-D and FIB in each patient was detected. Results: The concentrations of D-D and FIB in APE group were higher than those in non-APE group. The sensitivity, specificity, Youden index and the area under curve (AUC) of the ROC curve of D-D and FIB were 72.5%, 42.5%; 62.5%, 91.25%; 0.35, 0.338; 0.675 (95% CI: 0.597–0.747), 0.669 (95% CI: 0.590–0.741); respectively. In combined assay of D-D and FIB to test APE, the sensitivity, specificity, Youden index and the AUC of the ROC curve was 85.0%, 60.0%, 0.45, 0.773 (95% CI: 0.700–0.835).The area under the ROC curve of the combined assay of D-D and FIB was higher compared with the solo assay of D-D or FIB for testing APE, there was a significant difference (P<0.01). Conclusion: The combined assay of D-D and FIB has significantly clinical value and can be used in diagnosis of APE in type 2 diabetes mellitus patients.