摘要
目的探讨中性粒细胞/淋巴细胞(NLR)、红细胞分布宽度/血小板计数(RPR)预测骨盆及下肢骨折术后深静脉血栓(DVT)形成发生的应用价值。方法选取2019年1月至2019年12月在徐州医科大学附属医院行骨盆及下肢骨折手术治疗患者120例,其中术后发生DVT患者48例(DVT组),无DVT发生患者72例(非DVT组)。观察并比较两组术前及术后3 d血常规化验和凝血功能检验中各项指标的水平。组间比较分别采用χ^2检验、t检验及Mann-Whitney U检验,相关性分析采用二分类Logistic回归分析。结果DVT组术前及术后3 d NLR、术前RPR、术后3 d纤维蛋白原(FIB)与D-二聚体(D-D)分别为10.920±7.120、7.190±3.390、(0.090±0.040)%、(4.800±1.480)g/L、(5.960±3.370)mg/L,非DVT组分别为4.650±1.930、6.020±2.430、(0.058±0.020)%、(5.680±1.730)g/L、(3.910±3.060)mg/L,两组比较差异有统计学意义(t=-5.956、-2.065、-5.069、2.867、-3.458,P<0.05)。多因素Logistic回归分析显示,术前NLR、术前RPR及术后3 d D-D差异有统计学意义(比值比(OR)=1.171,95%可信区间(CI):1.016~1.350,P<0.05)。与术后D-D曲线下面积比较,术前NLR、术前NLR与术前RPR联合检测、术前NLR与术后D-D联合检测、术前RPR与术后D-D联合检测、三者联合检测的曲线下面积差异均有统计学意义(Z=1.730、2.368、2.278、2.200、2.814,P<0.05)。结论术前NLR、RPR及术后D-D在骨盆及下肢骨折术后深静脉血栓形成患者中表达水平升高,NLR与RPR联合检测的诊断效能优于D-D,而三者联合检测可提高诊断深静脉血栓的准确率。
Objective To evaluate the value of neutrophil/lymphocyte(NLR)and red blood cell distribution width/platelet count(RPR)in predicting the formation of deep venous thrombosis(DVT)after postoperative pelvic and lower extremity fractures.Methods 120 patients with pelvic and lower extremity fractures were selected from the Affiliated Hospital of Xuzhou Medical University,including 48 patients with postoperative DVT(DVT group)and 72 patients without DVT(non-DVT group).The results of blood routine test and coagulation function test before and 3 days after operation were observed and compared between the two groups.Results The preoperative and postoperative 3 d NLR,preoperative RPR,postoperative 3 d FIB and D-dimer(D-D)in DVT group were 10.920±7.120,7.190±3.390,(0.090±0.040)%,(4.800±1.480)g/L and(5.960±3.370)mg/L,respectively,and those in non-DVT group were 4.650±1.930,6.020±2.430,(0.058±0.020)%,(5.680±1.730)g/L and(3.910±3.060)mg/L,respectively.The difference was statistically significant(t=-5.956,-2.065,-5.069,2.867,-3.458,P<0.05).Multivariate Logistic regression analysis showed that there were significant differences in preoperative NLR,preoperative RPR and postoperative D-D.As compared with the area under curve(AUC)of postoperative D-D,the AUC of preoperative NLR,preoperative NLR+preoperative RPR,preoperative NLR+postoperative D-D,preoperative RPR+postoperative D-D,preoperative NLR+preoperative RPR+postoperative D-D showed significant differences(Z=1.730,2.368,2.278,2.200,2.814,P<0.05).Conclusion The expression level of preoperative NLR,RPR and postoperative D-D increased in patients with DVT after pelvic and lower limb fracture operation.The diagnostic efficiency of combined detection of preoperative NLR and RPR is better than that of postoperative D-D detection,and the combined detection of preoperative NLR,RPR and postoperative D-D can improve the accuracy of diagnosis of DVT.
作者
徐荣良
刘林
许铁
花嵘
张磊
张玉东
方堃
Xu Rongliang;Liu Lin;Xu Tie;Hua Rong;Zhang Lei;Zhang Yudong;Fang Kun(Department of Emergency,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China;The First School of Clinical Medicine,Xuzhou Medical University,Xuzhou 221004,China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2020年第2期363-365,共3页
Chinese Journal of Experimental Surgery
基金
徐州医科大学校级科研项目(2017KJ07)。
