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血清水平预测老年髋关节术后下肢深静脉血栓的价值研究OACSTPCDMEDLINE

Value of serum levels in predicting lower extremity deep vein thrombosis after hip joint surgery in the elderly

中文摘要英文摘要

目的:探索血清D-二聚体(D-dimer,D-D)、纤维蛋白原(fibrinogen,FIB)、血小板(platelet,PLT)、C反应蛋白(C-reactive protein,CRP)联合组织型纤溶酶原激活物抑制剂-1(plasminogen activator inhibitor-1,PAI-1)水平预测老年髋关节术后下肢深静脉血栓(deep vein thrombosis,DVT)的价值.方法:回顾性分析2020年2月至2022年5月收治的165例老年髋关节术患者,男89例,女76例;年龄60~75(66.43±5.48)岁;股骨颈骨折102例,股骨头坏死63例.所有患者入院24 h内均进行血清D-D、FIB、PLT、CRP、PAI-1检测,根据患者是否发生DVT分为DVT组和非DVT组.结果:DVT组患者的D-D、FIB、PLT、CRP、PAI-1水平均高于非DVT组(P<0.001);Spearman分析结果显示,DVT与PLT、CRP、D-D、FIB、PAI-1 水平均呈正相关性(r=0.382,0.213,0.410,0.310,0.353,均 P<0.001);二分类 Logistic 回归分析结果显示,D-D、PLT是影响 DVT发生的独立因素(OR=0.038,0.960,P=0.032,0.011);D-D、FIB、PLT、CRP、PAI-1 及五项联合预测DVT的曲线下面积(area under curve,AUC)分别为0.843、0.692、0.871、0.780、0.819、0.960,五项联合预测的AUC均高于单项预测(P<0.05).结论:D-D、FIB、PLT、CRP、PAI-1在预测老年髋关节术后发生DVT中具有一定效能,五项联合预测效能更高.

Objective To explore the value of serum D-dimer(D-D),fibrinogen(FIB),platelet(PLT),C-reactive pro-tein(CRP)and tissue plasminogen activator inhibitor(PAI)-1 levels in predicting lower extremity deep vein thrombosis(DVT)after hip joint surgery in the elderly.Methods A retrospective analysis was performed on 165 elderly patients with hip joint surgery admitted from February 2020 to May 2022,including 89 males and 76 females,aged from 60 to 75 years old with an average of(66.43±5.48)years,and there were 102 cases of femoral neck fracture and 63 cases of femoral head necrosis.Serum levels of D-D,FIB,PLT,CRP and PAI-1 tests were performed in all patients within 24 hours after admission,and the patients were divided into DVT group and non-DVT group according to whether they developed DVT.Results The levels of D-D,FIB,PLT,CRP,and PAI-1 in the DVT group were higher than those in the non-DVT group(P<0.001).Spearman analysis showed that DVT was positively correlated with PLT,CRP,D-D,FIB,and PAI-1 levels(r=0.382,0.213,0.410,0.310,0.353,all P<0.001).The results of binary Logistic regression analysis showed that D-D and PLT were independent factors affecting the occurrence of DVT(OR=0.038,0.960,P=0.032,0.011).The area under curve(AUC)of D-D,FIB,PLT,CRP,PAI-1,and the five combined predictions for DVT were 0.843,0.692,0.871,0.780,0.819,and 0.960,respectively.The AUC of the five combined predictions was higher than that of the single prediction(P<0.05).Conclusion D-D,FIB,PLT,CRP and PAI-1 are effective in predicting DVT after hip surgery in the elderly,and the combined prediction of the five factors has higher effi-cacy.

杨颖;尹茯颐;冷嫄娴;李国红

成都市第三人民医院骨科,四川 成都 610031

临床医学

D-二聚体C反应蛋白血小板纤维蛋白原组织型纤溶酶原激活物抑制剂髋关节下肢深静脉血栓

D-dimerC-reactive protein(CRP)PlateletFibrinogenPlasminogen activator inhibitor(PAI)Hip jointLower extremity deep vein thrombosis

《中国骨伤》 2024 (005)

500-504 / 5

10.12200/j.issn.1003-0034.20221292

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