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纤维蛋白相关标志物在围手术期静脉血栓栓塞症诊断中的作用分析

Analysis of the diagnostic role of fibrin-related markers in perioperative venous thromboembolism.

作者信息

Wei Min, Pan Yongjiang, Qin Zheng, Chen Lihua, Zhao Liping, Zhong Debin

机构信息

Medical Laboratory Department, Nanning First People's Hospital, Nanning, China.

出版信息

Front Surg. 2025 May 20;12:1530576. doi: 10.3389/fsurg.2025.1530576. eCollection 2025.

Abstract

OBJECTIVES

To investigate the diagnostic role of fibrin-related markers in the perioperative venous thromboembolism (VTE).

METHODS

A total of 100 high-risk perioperative patients, identified using the Caprini thrombosis risk assessment model [46 with deep vein thrombosis (DVT) and 54 with pulmonary embolism (PE)], were included as study subjects. Additionally, 50 healthy volunteers undergoing medical checkups during the same period served as controls. The levels of D-dimer, fibrin monomer (FM) and fibrin degradation products (FDP) were compared between patients and the control group across different time points. Additionally, the influence of various factors on these biomarkers was assessed. Furthermore, the diagnostic value of fibrin-related markers in perioperative VTE among surgical patients was analyzed.

RESULTS

The levels of D-dimer, FM and FDP on postoperative days 1, 3 and 7 were significantly lower than those on the day before surgery, showing a sequential decline over the postoperative period ( < 0.05). The levels of these three markers were significantly higher in the PE group than in the DVT group, and higher in the DVT group than in the control group ( < 0.05). No significant differences were observed in these markers based on gender, age or disease conditions ( > 0.05). Additionally, ROC curve analysis indicated that FM detection alone had good diagnostic value, with an AUC of 0.835 and a sensitivity of 88.34%. And joint detection (D-dimer, FM, FDP) provided superior diagnostic performance.

CONCLUSION

The combination of D-dimer, FM, FDP and Caprini scores may enhance the diagnostic accuracy of VTE in the perioperative period. If all four indicators are not readily available, monitoring FM levels alone can provide valuable diagnostic insight.

摘要

目的

探讨纤维蛋白相关标志物在围手术期静脉血栓栓塞症(VTE)中的诊断作用。

方法

采用Caprini血栓形成风险评估模型确定100例围手术期高危患者作为研究对象(其中46例发生深静脉血栓形成[DVT],54例发生肺栓塞[PE])。另外,选取同期进行体检的50名健康志愿者作为对照。比较患者组和对照组在不同时间点的D-二聚体、纤维蛋白单体(FM)和纤维蛋白降解产物(FDP)水平。此外,评估各种因素对这些生物标志物的影响。进一步分析纤维蛋白相关标志物在外科手术患者围手术期VTE中的诊断价值。

结果

术后第1天、第3天和第7天的D-二聚体、FM和FDP水平显著低于手术前一天,且在术后期间呈逐渐下降趋势(P<0.05)。这三种标志物的水平在PE组显著高于DVT组,在DVT组显著高于对照组(P<0.05)。基于性别、年龄或疾病状况,这些标志物未观察到显著差异(P>0.05)。此外,ROC曲线分析表明,单独检测FM具有良好的诊断价值,AUC为0.835,灵敏度为88.34%。联合检测(D-二聚体、FM、FDP)具有更优的诊断性能。

结论

D-二聚体、FM、FDP与Caprini评分相结合可能提高围手术期VTE的诊断准确性。如果无法同时获得这四项指标,单独监测FM水平也能提供有价值的诊断信息。

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