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类风湿关节炎患者术前红细胞沉降率可预测全膝关节置换术后深静脉血栓形成。

Preoperative erythrocyte sedimentation rate in patients with rheumatoid arthritis predicts deep vein thrombosis following total knee arthroplasty.

作者信息

Ying Pu, Lu Tong, Xu Yue, Miu Yiming, Xue Yi, Huang Zhihui, Ding Wenge, Dai Xiaoyu

机构信息

Department of Orthopedics, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, Jiangsu, China.

Department of Orthopedics, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.

出版信息

Clin Hemorheol Microcirc. 2022;81(1):23-31. doi: 10.3233/CH-211286.

Abstract

PURPOSE

To thoroughly evaluate preoperative risk factors for deep venous thrombosis (DVT) in patients with knee rheumatoid arthritis (RA) undergoing unilateral total knee arthroplasty (TKA).

METHODS

Clinical data of 106 patients with knee RA who underwent unilateral TKA from August 2014 to October 2020 were collected. All patients received ultrasonic examination of the veins of both lower extremities on the third day after TKA and were divided into DVT and non-DVT groups. The associations between age, gender, body mass index (BMI), history of diabetes/hypertension, common serum lipid levels, indicators related to coagulation function, blood viscosity, erythrocyte sedimentation rate (ESR) and postoperative DVT were statistically compared and analyzed.

RESULTS

ESR was significantly correlated with DVT risk after TKA (OR = 1.844, 95% CI = 1.022-2.981, P = 0.019). Receiver operating characteristic (ROC) curve analysis showed the optimal cut-off point of ESR for predicting DVT was 42 mm/h with a sensitivity of 95.5% and specificity of 66.7%.

CONCLUSION

An increased preoperative ESR value is a risk factor for DVT in patients with knee RA following unilateral TKA. Pre-surgery control of ESR level and prevention of postoperative DVT in these patients are worthy of attention.

摘要

目的

全面评估接受单侧全膝关节置换术(TKA)的膝关节类风湿关节炎(RA)患者深静脉血栓形成(DVT)的术前危险因素。

方法

收集2014年8月至2020年10月期间106例行单侧TKA的膝关节RA患者的临床资料。所有患者在TKA术后第3天接受双下肢静脉超声检查,并分为DVT组和非DVT组。对年龄、性别、体重指数(BMI)、糖尿病/高血压病史、常见血脂水平、凝血功能相关指标、血液黏度、红细胞沉降率(ESR)与术后DVT之间的相关性进行统计学比较和分析。

结果

ESR与TKA术后DVT风险显著相关(OR = 1.844,95%CI = 1.022 - 2.981,P = 0.019)。受试者工作特征(ROC)曲线分析显示,预测DVT的ESR最佳截断点为42mm/h,敏感性为95.5%,特异性为66.7%。

结论

术前ESR值升高是单侧TKA术后膝关节RA患者发生DVT的危险因素。术前控制这些患者的ESR水平并预防术后DVT值得关注。

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