目的：评价Wells量表和修正的Geneva评分系统联合D-二聚体诊断肺栓塞的意义。方法应用受试者工作特征曲线，通过Wells量表和修正的Geneva评分系统联合D-二聚体检验方法，得出修正的Geneva和Wells评分，联合D-二聚体阳性来比较两种方法的差别。结果通过Wells评分的ROC曲线得出以≥4．25作为预测值，其灵敏度30．2％，特异度92．6％；通过Geneva评分的ROC曲线得细化以≥6．5作为预测值，其灵敏度64．7％，特异度85．2％。在Wells评分中以最佳分界值4．25分为界，Geneva评分中以最佳分界值6．5分为界，联合D-二聚体检测准确率有明显差别。结论根据Geneva评分≥6．5分或Wells评分≥4．25分者联合D-二聚体阳性时，高度怀疑肺栓塞。%Objective To evaluate the validity of Wells’ Criteria and Geneva Scoring System combined with D-dimer as two different methods for predicting pulmonary embolism.Method The Wells score and the Geneva score were first obtained by the Wells’ Criteria and the Geneva Scoring System ( revised) combined with D – dimer respectively.The validity of the two methods was then evaluated and compared for their difference in accuracy sensitivity, and specificity.Findings The Wells score evaluated by the ROC curve was≥4.25 as the predictive value.Its sensitivity was 30.2%and its specificity of 92.6%.The Geneva score evaluated by the ROC curve was refined to≥6.5 as the predictive value.Its sensitivity was 64. 7%and its specificity of 85.2%.Of the Wells scores the best cutoff value was 4.25 while of the Geneva optimal the optimal cutoff score was 6.5.Combined with D-dimer, significant difference could be found between the two methods. Conclusion The sensitivity and specificity of the revised Geneva score were better than those of the Wells rule.When the revised Geneva scores arrive at a value≥6.5 or the Wells scores arrive a value≥4.25, and the D-dimer is positive, higher risk of pulmonary embolism can be predicted.
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