[1]杜治国,何 龙,黄 进,等.下肢创伤骨折后静脉血栓栓塞症相关检测项目分析[J].医学信息,2019,32(10):64-66.[doi:10.3969/j.issn.1006-1959.2019.10.022]
　DU Zhi-guo,HE Long,HUANG Jin,et al.Analysis of Related Items of Venous Thromboembolism after Traumatic Fracture of Lower Extremity[J].Journal of Medical Information,2019,32(10):64-66.[doi:10.3969/j.issn.1006-1959.2019.10.022]
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下肢创伤骨折后静脉血栓栓塞症相关检测项目分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年10期
页码:
64-66
栏目:
论著
出版日期:
2019-05-15

文章信息/Info

Title:
Analysis of Related Items of Venous Thromboembolism after Traumatic Fracture of Lower Extremity
文章编号:
1006-1959（2019）10-0064-03
作者:
杜治国; 何 龙; 黄 进; 邹 琴
（武汉市第四医院/华中科技大学同济医学院附属普爱医院检验科，湖北 武汉 430033）
Author(s):
DU Zhi-guo; HE Long; HUANG Jin; ZOU Qin
(The Fourth Hospital of Wuhan/Department of Clinical Laboratory,Pu'ai Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,Hubei,China)
关键词:
D-二聚体; C反应蛋白; 血小板; 创伤骨折; 静脉血栓栓塞症
Keywords:
D-dimer; C-reactive protein; Platelets; Traumatic fractures; Venous thromboembolism
分类号:
R683.42
DOI:
10.3969/j.issn.1006-1959.2019.10.022
文献标志码:
A
摘要:
目的 分析D-二聚体、C反应蛋白（CRP）及血小板（PLT）检测在下肢创伤骨折后静脉血栓栓塞症（VTE）中的临床应用。方法 回顾分析2017年1月~2018年1月我院收治的下肢骨创伤患者84例，按照纳入及排除标准确诊VT患者作为VTE组（40例），排除VTE患者作为非VTE组（44例），另选择同期来我院体检的健康者作为对照组（40例）。比较三组血浆D-二聚体、CRP及PLT水平，并对有差异的检测项目与VTE之间进行多因素Logistic回归分析，同时绘制受试者工作曲线（ROC）分析各项目对VTE的诊断效率。结果 VTE组和非VTE组D-二聚体阳性率、CRP阳性率均高于对照组，且VTE组CRP阳性率高于非VTE组，差异有统计学意义（P＜0.05），而VTE组与非VTE组间D-二聚体阳性率比较，差异无统计学意义（P＞0.05）。三组PLT水平比较，差异无统计学意义（P＞0.05）。下肢创伤骨折患者的多因素Logistic回归分析显示：CRP≥20 mg/L、D-二聚体≥5 mg/L和3 mg/L＜D-二聚体＜5 mg/L为VTE发生的危险因素，且其水平越高危险性越大。D-二聚体联合CRP诊断VTE的曲线下面积（AUC）为0.857，高于单独D-二聚体和CRP诊断的0.815和0.702。结论 下肢骨创伤患者D-二聚体、CRP水平升高为VTE发生的危险因素，且其水平越高危险性越大。D-二聚体和CRP水平联合检测应用于筛选和预测下肢骨创伤后VTE有一定的临床价值，而PLT水平检测对于下肢骨创伤后VTE诊断无临床价值。
Abstract:
Objective To analyze the clinical application of D-dimer, C-reactive protein (CRP) and platelet (PLT) in the detection of venous thromboembolism (VTE) in lower extremity traumatic fractures. Methods A retrospective analysis of 84 patients with lower extremity bone trauma admitted to our hospital from January 2017 to January 2018 was performed. According to the inclusion and exclusion criteria, VT patients were diagnosed as VTE group (40 cases), and VTE patients were excluded as non-VTE group (44 cases). In addition, the healthy person who came to our hospital for the same period of time was selected as the control group (40 cases). Three groups of plasma D-dimer, CRP and PLT levels were compared, and multivariate logistic regression analysis was performed between the different test items and VTE. The receiver operating curve (ROC) was also analyzed to analyze the VTE diagnosis of each item. effectiveness. Results The positive rate and positive CRP rate of D-dimer in VTE group and non-VTE group were higher than those in control group, and the positive rate of CRP in VTE group was higher than that in non-VTE group,the difference was statistically significant (P<0.05).There was no significant difference in the positive rate of D-dimer between VTE group and non-VTE group (P>0.05). There was no significant difference in the PLT levels between the three groups (P>0.05). Multivariate logistic regression analysis of patients with lower extremity trauma fractures showed: CRP≥20 mg/L,D-dimer≥5 mg/L and 3 mg/L

参考文献/References:

[1]Malone PC,Agutter PS.Deep venous thrombosis:The valve cusp hypoxia thesis and its incompatibility with modern orthodoxy[J].Med Hypotheses,2016(86):60-66.
[2]Khalafallah A,Jarvis C,Morse M,et al.Evaluation of the innovance D-dimer assay for the diagnosis of disseminated intravascular coagulopathy in different clinical settings[J].Clin Appl Thromb Hemost,2014,20(1):91-97.
[3]Wells PS.Pulmonary embolism:a clinician's perspective[J].Semin Nucl Med,2008,38(6):404-411.
[4]Shih L,Kaplan D,Kraiss LW,et al.Platelet-Monocyte Aggregates and C-Reactive Protein are Associated with VTE in Older Surgical Patients[J].Sci Rep,2016(6):27478.
[5]Niikura T,Sakai Y,Lee SY,et al.D-dimer levels to screen for venous thromboembolism in patients with fractures caused by high-energy injuries[J].J Orthop Sci,2015,20(4):682-688.
[6]董玉金,张铁慧,钟声,等.创伤骨折患者深静脉血栓形成的危险因素分析[J].中华骨科杂志,2015,35(11):1077-1083.
[7]Kunutsor SK,Seidu S,Blom AW.Serum C-reactive protein increases the risk of venous thromboembolism: a prospective study and meta-analysis of published prospective evidence[J].Eur J Epidemiol,2017,(32):657-667.
[8]中国健康促进基金会血栓与血管专项基金专家委员会,中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会.医院内静脉血栓栓塞症防止与管理建议[J].中华医学杂志,2018,98(18):1383-1388.

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更新日期/Last Update: 2019-05-15