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[血清水平在预测老年髋关节置换术后下肢深静脉血栓形成中的价值]

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

作者信息

Yang Ying, Yin Fu-Yi, Leng Yuan-Xian, Li Guo-Hong

机构信息

Department of Orthpaedics, Chengdu Third People's Hospital, Chengdu 610031, Sichuan, China.

出版信息

Zhongguo Gu Shang. 2024 May 25;37(5):500-4. doi: 10.12200/j.issn.1003-0034.20221292.

Abstract

OBJECTIVE

To explore the value of serum D-dimer (D-D), fibrinogen (FIB), platelet (PLT), C-reactive protein (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 (<0.001). Spearman analysis showed that DVT was positively correlated with PLT, CRP, D-D, FIB, and PAI-1 levels (=0.382, 0.213, 0.410, 0.310, 0.353, all <0.001). The results of binary Logistic regression analysis showed that D-D and PLT were independent factors affecting the occurrence of DVT (=0.038, 0.960, =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 (<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 efficacy.

摘要

目的

探讨血清D-二聚体(D-D)、纤维蛋白原(FIB)、血小板(PLT)、C反应蛋白(CRP)及组织型纤溶酶原激活物抑制剂(PAI)-1水平对老年髋关节置换术后下肢深静脉血栓形成(DVT)的预测价值。

方法

回顾性分析2020年2月至2022年5月收治的165例老年髋关节置换术患者,其中男89例,女76例,年龄60~75岁,平均(66.43±5.48)岁,股骨颈骨折102例,股骨头坏死63例。所有患者入院后24小时内检测血清D-D、FIB、PLT、CRP及PAI-1水平,并根据是否发生DVT分为DVT组和非DVT组。

结果

DVT组D-D、FIB、PLT、CRP及PAI-1水平高于非DVT组(<0.001)。Spearman分析显示,DVT与PLT、CRP、D-D、FIB及PAI-1水平呈正相关(=0.382、0.213、0.410、0.310、0.353,均<0.001)。二元Logistic回归分析结果显示,D-D和PLT是影响DVT发生的独立因素(=0.038、0.960,=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(AUC)分别为0.843、0.692、0.871、0.780、0.819及0.960。五项联合预测的AUC高于单项预测(<0.05)。

结论

D-D、FIB、PLT、CRP及PAI-1对老年髋关节置换术后DVT具有良好的预测效能,五项联合预测效能更高。

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