RT杂志文章SR电子T1 d -二聚体升高和抗凝血缺乏预测重症COVID-19患者PE JF欧洲呼吸杂志JO Eur Respir J FD欧洲呼吸学会SP 2001811 DO 10.1183/13993003.01811-2020 VO 56 IS 4 A1 Mouhat, Basile A1 Besutti, Matthieu A1 B188bet官网地址ouiller, Kevin A1 Grillet, Franck A1 Monnin, Charles A1 Ecarnot, Fiona A1 Behr, Julien A1 Capellier, Gilles A1 Soumagne, Thibaud A1 pli - floury, Sébastien A1 Besch, Guillaume A1 Mourey，Guillaume A1 Lepiller, Quentin A1 Chirouze, Catherine A1 Schiele, François A1 Chopard, Romain A1 Meneveau, Nicolas YR 2020 UL //www.qdcxjkg.com/content/56/4/2001811.abstract AB背景2019冠状病毒病(COVID-19)可能易导致静脉血栓栓塞。我们在住院的COVID-19重症患者中确定了与ct肺血管造影(CTPA)确诊的肺栓塞(PE)独立相关的因素。方法在法国某地区COVID-19高发地区的一所大学医院因COVID-19住院的所有患者(n=349)中，我们分析了接受CTPA治疗的重症临床体征(脉搏血氧饱和度≤93%或呼吸频率≥30次·分钟−1)或快速临床恶化的患者。采用Firth惩罚最大似然估计进行多变量分析。结果162例(46.4%)患者行CTPA，平均±sd年龄65.6±13.0岁;67.3%男性(95% CI 59.5-75.5%)。44例(27.2%)患者被诊断为PE。房颤多为节段性，房颤相关右心室功能障碍发生率为15.9%。通过多变量分析，ctpa证实PE仅有的两个显著预测因素是d -二聚体水平和缺乏任何抗凝治疗(分别为每额外四分位数OR 4.0 (95% CI 2.4-6.7)和OR 4.5 (95% CI 1.1-7.4)。受试者工作特征曲线分析发现，d -二聚体截断值2590 ng·mL−1最能预测PE的发生(曲线下面积0.88,p<0.001，敏感性83.3%，特异性83.8%)。 D-dimer level >2590 ng·mL−1 was associated with a 17-fold increase in the adjusted risk of PE.Conclusion Elevated D-dimers (>2590 ng·mL−1) and absence of anticoagulant therapy predict PE in hospitalised COVID-19 patients with clinical signs of severity. These data strengthen the evidence base in favour of systematic anticoagulation, and suggest wider use of D-dimer guided CTPA to screen for PE in acutely ill hospitalised patients with COVID-19.We studied predictors of pulmonary embolism in severe COVID-19 and found that D-dimer level and lack of any anticoagulant therapy were associated with a 17-fold and four-fold increase in PE, respectively, in COVID-19 patients with clinical signs of severity https://bit.ly/2ETfAfo