摘要
目的 探讨血清25(OH)D水平联合血栓弹力图(thrombelastography, TEG)诊断下肢深静脉血栓形成(deep vein thrombosis, DVT)的价值。方法 选择收集2017年1月—2021年6月收治的疑似DVT患者共101例(研究组),所有患者经下肢血管B超确诊,并选取同一时期的健康体检者102名(对照组)。观察两组的基本临床特征、合并症、血清25(OH)D水平、TEG参数及其他必要的实验室指标,分析其与DVT的相关性;再基于血清25(OH)D水平,将参与者分为3个亚组(充足、不足、缺乏),分析联合TEG参数诊断DVT的价值。结果 研究组血清25(OH)D水平明显低于对照组(P<0.05),对照组的TEG参数R值、MA、LY30、EPL均高于研究组(P<0.05),对照组的TEG参数CI低于研究组(P<0.05)。在基于血清25(OH)D水平的3个亚组当中,可发现其水平存在明显差异(P<0.05),而TEG的参数MA、LY30、EPL、CI在亚组中也存在统计学差异(P<0.05)。Logistic回归分析发现,血清25(OH)D水平与TEG参数LY30(OR=0.604,95%CI:0.461~0.792)、CI(OR=1.681,95%CI:1.076~2.626)联合诊断呈现一定的交互作用。ROC曲线结果显示,血清25(OH)D水平联合TEG参数LY30和CI具有较高的诊断价值(AUC=0.96,P<0.05),而单独血清(25(OH)D诊断DVT具有中等价值(AUC=0.756,P<0.05)。结论 血清25(OH)D水平是一项可用于辅助诊断DVT的实验室检查指标,与TEG的部分参数LY30、CI联合时有着较高的诊断价值。
Objective To investigate the combination of thrombelastography(TEG) and serum 25(OH)D detection in diagnosis of deep vein thrombosis(DVT). Methods The clinical data of 101 DVT patients admitted to Shanghai Tenth Hospital from January 2017 to June 2021 were enrolled in the study(DVT group) and 102 healthy subjects were selected as control group. Serum 25(OH)D levels were measured and TEG was performed in all subjects;and the results were compared between two groups. According to the international criteria of serum 25(OH)D, patients were divided into sufficiency, insufficiency and deficiency subgroups. Results Serum 25(OH)D levels were significantly lower in the DVT group than those in the controls(P<0.05). TEG parameters R, MA, LY30 and EPL in the DVT group were lower, while CI was higher than those in the control group. There were significant differences in TEG parameters MA, LY30, EPL, CI among three 25(OH)D subgroups(P<0.05). Logistic regression analysis showed that serum 25(OH)D level, TEG parameters LY30(OR=0.604,95%CI: 0.461-0.792) and CI(OR=1.681,95%CI: 1.076-2.626) were independent predictors for DVT. The area under curve(AUC) of serum 25(OH)D level was 0.756(P<0.05) for predicting DVT, while the AUC of combination of 25(OH)D level with TEG parameters LY30 and CI was 0.96(P<0.05). Conclusion Serum 25(OH)D level and TEG parameters LY30 and CI can be used for diagnostic of DVT, and the combination of serum 25(OH)D level and TEG parameters has higher diagnostic value for DVT.
作者
胡超
谢晓云
吴永发
廉维帅
袁逸枫
程杰
李茂全
HU Chao;XIE Xiaoyun;WU Yongfa;LIAN Weishuai;YUAN Yifeng;CHENG Jie;LI Maoquan(School of Medicine,Tongji University,Shanghai 200092,China;Institute of Interventional Vascular Surgery,Tongji University,Shanghai 200072,China;Department of Interventional Vascular Surgery,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China)
出处
《同济大学学报（医学版）》
CAS
2023年第1期76-82,共7页
Journal of Tongji University(Medical Science)
