The value of the ischemia modified albumin or D-dimer combined with Wells scoring system in the diagnosis of pulmonary embolism

Objective: To investigate the value of the ischemia modified albumin(IMA),D-dimer combined with Wells scoring system in the diagnosis of pulmonary embolism(PE).Methods: Forty-six patients with suspected PE were examinated using multislice CT pulmonary angiography,and 20 PE cases,26 cases non-PE cases and 14 healthy people were divided into the PE group,non-PE group and control group,respectively.The levels of IMA and D-dimer in 3 groups were measured.The diagnostic value of IMA and D-dimer in PE patients were compared with ROC curve.Results: The levels of IMA and D-dimer in PE group were significantly higher than those in non-PE and control groups(P<0.01).The ROC curve showed that the most appropriate cut-off value of IMA was 63.45 U/mL,the sensitivity,specificity,positive predictive value and negative predictive value were 90.00%,76.90%,75.00% and 90.90%,respectively.The ROC curve showed that the most appropriate cut-off value of D-dimer was 0.795 mg/L,the sensitivity,specificity,positive predictive value and negative predictive value were 90.00%, 57.70%, 66.67% and 89.47%,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of IMA combined with Wells scoring in diagnosing PE were 99.00%,38.45%,54.89% and 98.20%,respectively,and the sensitivity,specificity,positive predictive value and negative predictive value of D-dimer combined with Wells scoring in diagnosing PE were 99.00%,28.85%,51.29% and 97.45%,respectively.Conclusions: IMA can be used to diagnose PE,the diagnostic specificity of IMA is higher than that of the plasma D-dimer.The positive predictive value of IMA combined with Wells scoring in diagnosing PE is higher than that of D-dimer combined with Wells scoring,but the negative predictive value and sensitivity of the IMA combined with Wells scoring are similar to the D-dimer combined with Wells scoring.