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血小板与淋巴细胞比值和 D-二聚体与纤维蛋白原比值联合 WELLS 评分对青年脑出血下肢深静脉血栓形成的预测价值。

The predictive value of platelet to lymphocyte ratio and D-dimer to fibrinogen ratio combined with WELLS score on lower extremity deep vein thrombosis in young patients with cerebral hemorrhage.

机构信息

Department of Neurology, Baoji Municipal Central Hospital, 8 Jiangtan Road, Baoji, 721008, Shaanxi, People's Republic of China.

出版信息

Neurol Sci. 2021 Sep;42(9):3715-3721. doi: 10.1007/s10072-020-05007-y. Epub 2021 Jan 14.

Abstract

OBJECTIVE

To study the predictive effect on YCH patients complicated with LEDVT by PLR and DFR combined with WELLS score.

MATERIALS AND METHODS

A total of 109 patients with YCH were selected as the research subjects. Patients with combined LEDVT were in the thrombosis group (33 cases), and without LEDVT in the non-thrombosis group (76 cases). Wells score was used to evaluate the vascular of the lower extremities. The PLR and DFR were calculated. The diagnostic value of PLR and DFR combined with the Wells score was evaluated by the AUC, sensitivity, specificity, and other indicators in the ROC.

RESULTS

The values of PLR, DFR, and Wells score in the thrombus group were 149.20 ± 52.17, 118.46 ± 8.37, and 2.67 ± 0.48, and that of the non-thrombotic group were 95.27 ± 29.48, 75.28 ± 10.16, and 0.72 ± 0.34, respectively. The differences were statistically significant. ROC results showed good diagnosis power of PLR (sensitivity 86.35%, specificity 75.18%, AUC 0.702.), DFR (sensitivity 88.57%, specificity 79.21%, AUC 0.786.), and the Wells score (sensitivity 90.17%, specificity 81.06%, AUC 0.889.). The combined application of the Wells score, PLR, and DFR for the occurrence of LEDVT had a sensitivity of 97.65%, a specificity of 92.43%, a missed diagnosis rate of 2.35%, and a misdiagnosis rate of 7.57%. The area under the ROC curve was 0.951, which was higher than using these variables independently.

CONCLUSIONS

PLR and DFR combined with Wells score have high specificity for predicting LEDVT in YCH patients with low missed diagnosis and low misdiagnosis rates. They are worthy of popularization and application.

摘要

目的

研究 PLR 和 DFR 联合 WELLS 评分对 YCH 患者并发 LEDVT 的预测效果。

材料和方法

选择 109 例 YCH 患者作为研究对象,下肢深静脉血栓形成患者为血栓组(33 例),无 LEDVT 为非血栓组(76 例)。采用 Wells 评分评估下肢血管,计算 PLR 和 DFR。通过 AUC、灵敏度、特异性等指标评价 PLR 和 DFR 联合 Wells 评分对预测 YCH 患者并发 LEDVT 的诊断价值。

结果

血栓组 PLR、DFR、Wells 评分分别为 149.20±52.17、118.46±8.37、2.67±0.48,非血栓组为 95.27±29.48、75.28±10.16、0.72±0.34,差异有统计学意义。ROC 结果显示 PLR(灵敏度 86.35%、特异度 75.18%、AUC 0.702)、DFR(灵敏度 88.57%、特异度 79.21%、AUC 0.786)、Wells 评分(灵敏度 90.17%、特异度 81.06%、AUC 0.889)诊断效能较好。联合应用 Wells 评分、PLR、DFR 预测 LEDVT 发生的灵敏度为 97.65%、特异度为 92.43%、漏诊率为 2.35%、误诊率为 7.57%,ROC 曲线下面积为 0.951,高于各变量单独应用。

结论

PLR 和 DFR 联合 Wells 评分对预测 YCH 患者 LEDVT 具有较高的特异性,漏诊率和误诊率低,值得推广应用。

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