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急性脊髓损伤患者 D-二聚体水平与深静脉血栓形成的相关性。

Correlation Between D-Dimer Level and Deep Venous Thrombosis in Patients With Acute Spinal Cord Injuries.

机构信息

From the Department of Rehabilitation Medicine, Keimyung University School of Medicine, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea (JHC); and Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea (JBK, DGL).

出版信息

Am J Phys Med Rehabil. 2020 Jul;99(7):613-616. doi: 10.1097/PHM.0000000000001383.

Abstract

OBJECTIVE

Venous thromboembolism is a serious life-threatening complication of S SCI. Measurement of D-dimer levels is used as a screening test for deep vein thrombosis. However, trauma, surgery, and motor weakness are known as factors that affect D-dimer levels. Thus, the aim of this study was to examine the correlation between D-dimer levels and deep vein thrombosis in relation to the comorbidities in acute spinal cord injury.

DESIGN

A retrospective observational study was conducted at a hospital's rehabilitation department. Forty-five patients without pharmacologic thromboembolic thromboprophylaxis 5-90 days after the onset of injury were enrolled.

RESULTS

Fourteen patients (31%) were diagnosed with deep vein thrombosis using duplex ultrasonography. The mean ± SD D-dimer levels were 2.15 ± 2.74 and 6.98 ± 7.46 μg/ml in the deep vein thrombosis-negative and deep vein thrombosis-positive groups, respectively. The lower limb motor index scores significantly correlated with D-dimer levels regardless of the time between the onset of spinal cord injury and D-dimer testing. Patients with trauma had significantly increased D-dimer levels compared with patients without trauma.

CONCLUSION

Although D-dimer levels have limitations with regard to the positive prediction of acute spinal cord injury, it is a useful screening parameter for deep vein thrombosis. Trauma and lower limb motor weakness should be considered when analyzing D-dimer levels.

摘要

目的

静脉血栓栓塞症是脊髓损伤后严重的危及生命的并发症。D-二聚体水平的测量可作为深静脉血栓形成的筛选试验。然而,创伤、手术和运动无力是已知影响 D-二聚体水平的因素。因此,本研究旨在探讨 D-二聚体水平与深静脉血栓形成与急性脊髓损伤合并症的相关性。

设计

这是一项在医院康复科进行的回顾性观察性研究。共纳入 45 例损伤后 5-90 天无药物性血栓栓塞预防的患者。

结果

14 例(31%)患者经双能超声诊断为深静脉血栓形成。深静脉血栓形成阴性组和深静脉血栓形成阳性组的 D-二聚体水平分别为 2.15±2.74μg/ml 和 6.98±7.46μg/ml。下肢运动指数评分与 D-二聚体水平显著相关,与脊髓损伤发生和 D-二聚体检测之间的时间无关。有创伤的患者的 D-二聚体水平明显高于无创伤的患者。

结论

尽管 D-二聚体水平对急性脊髓损伤的阳性预测有一定的局限性,但它是深静脉血栓形成的一种有用的筛选参数。分析 D-二聚体水平时应考虑创伤和下肢运动无力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c95b/7292501/1e3f3b926a39/phm-99-613-g002.jpg

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