摘要
目的探讨下肢骨折患者平均血小板体积/淋巴细胞比值(mean platelet volume/lymphocyte ratio,MPVLR)及可溶性血栓调节蛋白(soluble thrombolodulin,sTM)对术后下肢深静脉血栓(deep vein thrombosis,DVT)的联合预测价值。方法选择医院收治的下肢骨折患者89例,所有患者均接受手术治疗,根据患者术后是否发生下肢DVT分为发生组与非发生组。统计下肢骨折患者术后下肢DVT的发生情况,比较发生组与非发生组外周血MPVLR、sTM水平,比较发生组与非发生组的临床资料,Logistic多因素回归分析下肢骨折患者术后发生下肢DVT的影响因素,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,以曲线下面积(area under the curve,AUC)分析术前外周血MPVLR、sTM水平及二者联合对下肢骨折患者术后发生下肢DVT的预测价值。结果89例下肢骨折患者中术后发生下肢DVT 21例,发生率为23.60%(21/89),剩余68例均未发生下肢DVT。发生组外周血MPVLR、sTM水平高于非发生组,差异有统计学意义(P<0.05)。2组在年龄≥60岁、手术时间≥2 h、术后是否使用抗凝药物、体重指数、术后卧床时间差异有统计学意义(P<0.05)。Logistic多因素回归分析结果显示,年龄≥60岁、手术时间≥2 h、体重指数升高、外周血MPVLR水平升高、外周血sTM水平升高为下肢骨折患者术后发生下肢DVT的影响因素(P<0.05)。ROC曲线结果显示,术前外周血MPVLR、sTM水平及二者联合预测下肢骨折患者术后发生下肢DVT的AUC值分别为0.716、0.705、0.861(P<0.05),且二者联合预测的AUC值高于单独指标预测的AUC值(P<0.05)。结论术前检测外周血MPVLR、sTM可用于预测下肢骨折患者术后是否发生下肢DVT,且二者联合具有更高的预测价值。
Objective To investigate the predictive value of mean platelet volume/lymphocyte ratio(MPVLR)and soluble thrombolodulin(sTM)in postoperative deep vein thrombosis(DVT)of lower extremity in patients with lower extremity fracture.Methods A total of 89 patients with lower extremity fracture admitted to the hospital were selected.All patients received surgical treatment and were divided into the occurrence group and non-occurrence group according to whether the patients developed DVT of lower extremity after surgery.The incidence of DVT of lower extremity in patients with lower extremity fracture after surgery was analyzed,the levels of peripheral blood MPVLR and sTM in the occurrence and non-occurrence groups were compared,and the clinical data of the occurrence and non-occurrence groups were compared.The influencing factors of DVT of lower extremity in patients with lower extremity fracture after surgery were analyzed by multivariate Logistic regression,and receiver operating characteristic(ROC)curve was drawn.Area under the ROC curve(AUC)was used to analyze the predictive value of preoperative peripheral blood MPVLR and sTM levels alone and in combination for postoperative DVT of lower extremity in patients with lower extremity fracture.Results Postoperative DVT occurred in 21 of 89 patients with lower extremity fracture,with an incidence of 23.60%(21/89),and no DVT occurred in the remaining 68 patients.The levels of MPVLR and sTM in peripheral blood of the occurrence group were higher than those of the non-occurrence group,suggesting significant differences(P<0.05).There were significant differences between the two groups in age≥60 years,duration of operation≥2 h,postoperative use of anticoagulant drugs,body mass index(BMI)and duration of postoperative bed rest(P<0.05).Logistic regression analysis showed that age≥60 years,duration of operation≥2 h,increased BMI,MPVLR level and sTM level in peripheral blood were influencing factors for postoperative DVT of lower extremity in patients with lower extremity fracture(P<0.05).ROC curve results showed that the AUC values of preoperative peripheral blood MPVLR and sTM levels alone and in combination for prediction of postoperative DVT in patients with lower extremity fracture were 0.716,0.705 and 0.861,respectively(P<0.05),and the AUC value of the combined prediction of the two indexes was higher than that predicted by the single index(P<0.05).Conclusion Preoperative detection of peripheral blood MPVLR and sTM can be used to predict the occurrence of DVT of lower extremity in patients with lower extremity fracture,and the combination of the two has higher predictive value.
作者
汪妍妍
王旭
李佳
WANG Yan-yan;WANG Xu;LI Jia(Department of Trauma Surgery,Subei People's Hospital of Yangzhou City,Jiangsu Province,Yangzhou 225009,China;Department of Orthopedics,Subei People's Hospital of Yangzhou City,Jiangsu Province,Yangzhou 225009,China)
出处
《河北医科大学学报》
CAS
2024年第8期946-951,共6页
Journal of Hebei Medical University
基金
江苏省科技计划专项资金(基础研究计划自然科学基金(BK20221280))。
