P选择素、抗心磷脂抗体及活化蛋白C抵抗预测下肢创伤骨折术后深静脉血栓形成的临床研究  

Applied value of P-selectin,anticardiolipin antibody and activated protein c resistance in predicting deep venous thrombosis after the surgery for treatment of traumatic lower extremity fractures:a clinical study

作　　者：马远[1] 叶向阳[1] 程省[1] 郭雄飞[1] MA Yuan;YE Xiangyang;CHENG Sheng;GUO Xiongfei(Nanyang Central Hospital,Nanyang 473003,Henan,Chin)

机构地区：[1]南阳市中心医院

出　　处：《中医正骨》2019年第8期31-34,共4页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨P选择素、抗心磷脂抗体(anticardiolipin antibody,ACA)及活化蛋白C抵抗(activated protein c resistance,APCR)对下肢创伤骨折术后深静脉血栓形成(deep venous thrombosis,DVT)的预测价值。方法:选择接受手术治疗的下肢创伤骨折患者,术后第3天抽取患者静脉血,采用酶联免疫吸附法测定P选择素含量和ACA阳性率,采用Dahlback法测定APCR阳性率。按照《深静脉血栓形成的诊断和治疗指南(第三版)》中DVT的诊断标准判断患者术后2周内是否发生DVT,比较DVT组和无DVT组的血清P选择素含量、血清ACA阳性率及血清APCR阳性率。以是否发生DVT为因变量,以血清P选择素、ACA及APCR为自变量,进行多因素Logistic回归分析。结果:共纳入648例患者,其中31例患者术后2周内发生DVT(DVT组),其余617例均未检出DVT(无DVT组)。2组患者的血清P选择素含量、血清ACA阳性率及血清APCR阳性率比较,差异均有统计学意义(t=26.989,P=0.000;χ^2=0.010,P=0.000;χ^2=12.447,P=0.000)。多因素Logistic回归分析结果显示,血清P选择素、ACA及APCR是下肢创伤骨折术后DVT的危险因素(OR=1.219,P=0.019;OR=1.292,P=0.009;OR=2.430,P=0.012)。结论:P选择素、ACA及APCR是下肢创伤骨折术后DVT的危险因素,可作为预测下肢创伤骨折术后DVT的检测指标。Objective:To explore the applied value of P-selectin,anticardiolipin antibody(ACA)and activated protein c resistance(APCR)in predicting deep venous thrombosis(DVT)after the surgery for treatment of traumatic lower extremity fractures.Methods:The patients who received surgery for traumatic lower extremity fractures were selected and their blood was drawn from veins at the 3 rd day after surgery.The content of P-selectin and positive rate of ACA were detected by using enzyme-linked immunoadsordent assay,and the positive rate of APCR was detected by using Dahlback method.The patients were divided into DVT group and non-DVT group according to whether DVT was found within 2 weeks after surgery in accordance with the diagnostic standards of DVT which was extracted from Guidelines for Diagnosis and Treatment of Deep Venous Thrombosis(3rd edition).The serum content of P-selectin and positive rate of serum ACA and serum APCR were compared between the 2 groups.The multiple-factor Logistic regression analysis was conducted by chosing occurrence of DVT as the dependent variable and chosing serum P-selectin,ACA and APCR as independent variables.Results:Six hundred and forty-eight patients were included in the study.DVTs were found in 31 patients(DVT group)and unfound in 617 patients(non-DVT group)within 2 weeks after surgery.There was statistical difference in serum content of P-selectin and positive rate of serum ACA and serum APCR between the 2 groups(t=26.989,P=0.000;χ^2=0.010,P=0.000;χ^2=12.447,P=0.000).The result of multiple-factor Logistic regression analysis demonstrated that the serum P-selectin,ACA and APCR were the risk factors for DVT following the surgery for treatment of traumatic lower extremity fractures(OR=1.219,P=0.019;OR=1.292,P=0.009;OR=2.430,P=0.012).Conclusion:P-selectin,ACA and APCR are the risk factors for DVT following the surgery for treatment of traumatic lower extremity fractures,and they may serve as the detection indicators for the prediction of DVT after the surgery for treatment of traumatic l

关 键 词：静脉血栓形成 下肢骨 骨折 P选择素 抗心磷脂抗体 活化蛋白C抵抗 

分 类 号：R47[医药卫生—护理学]