骨折并发深静脉血栓形成患者FDP、DD的截断值确定  

Determination of cut-off values of FDP and DD in fracture patients complicated with deep venous thrombosis

作　　者：陈海生[1] 张梦梦[1] 丁云霞[2] 吴英[1] 

机构地区：[1]佛山市中医院检验科,528000 [2]佛山市中医院骨十科,528000

出　　处：《国际医药卫生导报》2016年第14期2086-2089,共4页International Medicine and Health Guidance News

摘　　要：目的 找出FDP、DD在骨折创伤患者并发深静脉血栓形成中的临床诊断截断值并分析其价值.方法 回顾性分析病例,筛选得到76例骨折并发DVT患者和88例骨折但未并发DVT患者病例,收集汇总患者的FDP、DD检测结果,通过方差齐性校正t检验分析其差异是否具统计学意义,同时通过绘制受检者工作特征（ROC）曲线确定各自的临床诊断截断值.结果 （1）骨折并发DVT患者与骨折但未并发DVT患者相比,前者的FDP、DD水平明显比后者增高（P＜0.01）;（2）并发DVT患者FDP的ROC曲线下面积（AUC）为0.714 （SD：0.04;95CI：0.635-0.792）,截断高值为31.4μg/ml（敏感度0.395,特异性0.909,Youden指数0.304,阴性似然比0.665）,截断低值为2.50μg/ml（敏感度0.974,特异性0.227,Youden指数0.201,阴性似然比0.115）;（3）并发DVT患者DD的ROC曲线下面积（AUC）为0.721（SD：0.04;95CI：0.643-0.8）,截断高值为15.5μg/ml（敏感度0.329,特异性0.909,Youden指数0.238,阴性似然比0.738）,截断低值为1.00μg/ml（敏感度0.987,特异性0.148,Youden指数0.135,阴性似然比0.088）.结论 本研究中FDP、DD临床截断高值有90％以上的特异度,可以为DVT的早期诊断提供参考,即在检测结果大于截断值时建议直接予以临床干预治疗,截断低值能在一定程度上排除了DVT的可能性,减少不必要的影像学检查,减少病人的痛苦和负担,节约医疗资源,对于医疗事业的发展有重大意义.Objective To find out the clinical diagnostic cut-off values of FDP and DD in fracture patients complicated with deep venous thrombosis （DVT） and to analyze their value.Methods 76 fracture patients complicated with DVT（DVT group） and 88 fracture patients without DVT （non-DVT group） were selected.The detection results of FDP and DD in both groups were collected and summarized.The clinical data of all the patients were done by F t test to analyze whether it had statistical difference.The examinees＆#39; ROC were drawed to determine the cut-off values.Results The levels of FDP and DD were obviously higher in the DVT group than in the non-DVT group （P〈0.01）.The area under the ROC of FDP was 0.714 （SD：0.04,95 Cl：0.635-0.792） in the DVT group.The upper cut-off value of FDP in the fracture patients complicated with DVT was 31.4μg/ml （sensitivity 0.395;specificity 0.909;Youden＆#39;s index 0.304;negative likelihood Ratio 0.665） and the lower 2.50 μg/ml（sensitivity 0.974;specificity 0.227;Youden＆#39;s index 0.201;negative likelihood Ratio 0.115）.The area under the ROC of DD was 0.721 （SD：0.04;95C1：0.643～0.8） in the DVT group.The upper cut-off value of DD in the fracture patients complicated with DVT was 15.5 μg/ml （sensitivity 0.329;specificity 0.909;Youden＆#39;s index 0.238;negative likelihood Ratio 0.738） and the lower 1.00 μg/ml（sensitivity 0.987;specificity 0.148;Youden＆#39;s index 0.135;negative likelihood Ratio 0.088）.Conclusions In this study,the clinical cut-off values of FDP and DD have true negative rates more than 90%,which can provide a reference for the early diagnosis of DVT,it means that doctors should directly use medicine to treat the patients when theirs results of FDP and DD are more than the cut-off values,which can reduce the patients＆#39; pain,save medical resources,and even promote the development of medical industry.

关 键 词：截断值 深静脉血栓形成 D-二聚体 ROC曲线 

分 类 号：R543.6[医药卫生—心血管疾病]