林江川 1郭木英 1陈腾飞 1蔡志雄 2郑剑志 1涂国玩1
作者信息
- 1. 德化县医院 福建 德化 362500
- 2. 福建医科大学孟超肝胆医院
- 折叠
摘要
Abstract
Objective:To analyze the risk factors of deep vein thrombosis of lower extremities in patients with severe neurological diseases and predictive value of molecular markers of prethrombotic state.Method:The medical records of 80 patients who admitted to Dehua County Hospital from February 2021 to February 2023 were retrospectively analyzed.The patients were divided into the thrombosis group(n=39)and the non-thrombosis group(n=41)according to whether thrombosis occurred 3 d after operation,the medical records and preoperative levels of molecular markers of prethrombotic state[tissue plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC),thrombin-antithrombin complex(TAT),plasmin-2α plasmin inhibitor complex(PIC),thrombomodulin(TM)]were compared between two groups,univariate and multivariate logistic regression were used to analyze the risk factors for deep vein thrombosis of lower extremities in patients with severe neurological disease,and the predictive value of t-PAIC,TAT,PIC and TM on deep vein thrombosis of lower extremities in patients with severe neurological disease was analyzed by plotting the receiver working characteristics(ROC)curve.Result:There were significant differences in age,right lower limb muscle strength,bed rest time,lower limb deep vein puncture,lower limb braking,white blood cell(WBC),fibrinogen(FIB),D-dimer(D-D),t-PAIC,TAT,PIC,TM,acute physiology and chronic health scores system(APACHEⅡ)score and Caprini score between two groups(P<0.05).Multivariate logistic analysis showed that age≥65 years old,lower extremity immobilization,D-D elevation,t-PAIC,TAT,PIC,TM,Caprini scores were independent risk factors for of deep vein thrombosis of lower extremities in patients with severe neurological disease(P<0.05);ROC curve showed that the area under ROC curve(AUC)of TM,TAT,PIC,t-PAIC and combined prediction were 0.672,0.837,0.789,0.633 and 0.887,respectively.Conclusion:The levels of t-PAIC,TAT,PIC and TM before thrombosis are independent risk factors for deep vein thrombosis of low extremities in patients with severe neurological diseases,combined detection can early identify high-risk patients with deep vein thrombosis of lower extremities in patients with severe neurological diseases.关键词
血栓前状态分子标志物/神经重症患者/下肢深静脉血栓Key words
Molecular markers of prethrombotic state/Patients with severe neurological diseases/Deep vein thrombosis of lower extremities
