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