Hcy、D-D、IL-18、hs-CRP联合检测对老年下肢深静脉血栓形成诊断及预后判断的临床意义  

The clinical significance of combined detection of Hcy, D-D, IL-18 and hs-CRP in the diagnosis and prognosis of lower extremity deep vein thrombosis in aged patients

作　　者：刘希龙[1] 杜振元 刘日旭[1] LIU Xilong;DU Zhenyuan;LIU Rixu(Laboratory Medicine,Xinhua Hospital Affiliated to Dalian University,Dalian 116000,China;Laboratory Medicine,Chaoyang Second Hospital in Dalian Province,Chaoyang122000,China)

机构地区：[1]大连大学附属新华医院检验科,辽宁大连116000 [2]辽宁省朝阳市第二医院检验科,辽宁大连122000

出　　处：《中国现代医生》2020年第7期125-128,共4页China Modern Doctor

摘　　要：目的探讨同型半胱氨酸(Hcy)、D-二聚体(D-D)、白介素-18(IL-18)、高敏-C反应蛋白(hs-CRP)联合检测在老年下肢深静脉血栓形成(Lower extremity deep venous thrombosis,LEDVT)诊断及预后判断中的应用价值。方法选取2016年1月~2019年6月我院收治的150例老年下肢骨折患者,根据其是否并发LEDVT分成观察组与对照组。将其中38例并发LEDVT的患者设为LEDVT组,112例未发生LEDVT的患者设为非LEDVT组,同时选取30例老年健康体检者(HC)作为HC组。分别检测所有对象血清中Hcy(酶循环法)、D-D(免疫比浊法)、IL-18(酶联免疫法)、hs-CRP(乳胶免疫比浊法)水平。结果LEDVT组血清Hcy、D-D、IL-18、hs-CRP浓度较非LEDVT组及HC组均有显著增高(P<0.05),且非LEDVT组以上各项指标水平亦均显著高于HC组(P<0.05)。上述各项血清指标(Hcy、D-D、IL-18、hs-CRP)对LEDVT诊断的准确度由高到低分别为IL-18(82.00%)、Hcy(76.67%)、hs-CRP(75.33%)、D-D(74.67%),其中D-D、hs-CRP的敏感度高,但特异度低,Hcy的敏感度低,但特异度较高。预后良好组血清Hcy、D-D、IL-18、hs-CRP含量均显著低于预后不良组(P<0.05)。结论联合检测血清中Hcy、D-D、IL-18、hs-CRP水平有助于老年LEDVT的诊断及预后判断。Objective To explore the value of the detection of homocysteine(Hcy),D-Dimer(D-D),interleukin-18(IL-18)and high sensitive C-reactive protein(hs-CRP)in the diagnosis and prognosis of lower extremity deep vein thrombosis(LEDVT)in aged patients.Methods 150 elderly patients with lower extremity fracture treated in our hospital from January 2016 to June 2019 were selected and divided into observation group and control group based on whether LEDVT was presented.38 patients with LEDVT were divided into LEDVT group and 112 patients without LEDVT were divided into non-LEDVT group.At the same time,30 healthy aged people were selected as HC group.The levels of Hcy,D-D,IL-18 and hs-CRP in serum were detected using enzymatic cycling methods,immunoturbidimetry,euzymelinked immunosorbent assay and latex-enhanced immunoturbidimetry,respectively.Results The concentrations of Hcy,D-D,IL-18 and hs-CRP in LEDVT group were significantly higher than those in non-LEDVT group and HC group(P<0.05),and the levels of above indexes in non-LEDVT group were also significantly higher than those in HC group(P<0.05).The accuracy of the above serum indexes(Hcy,D-D,IL-18,hs-CRP)in the diagnosis of LEDVT was in high-low order,among which IL-18 was 82.00%,Hcy was 76.67%,hs-CRP was 75.33%,D-D was 74.67%,and the sensitivity of D-D and hs-CRP was high,but the specificity was low,and the sensitivity of Hcy was low,but the specificity was high.The levels of Hcy,D-D,IL-18 and hs-CRP in the group with good prognosis were significantly lower than those in the group with poor prognosis(P<0.05).Conclusion The combined detection of Hcy,D-D,IL-18 and hs-CRP in serum is helpful to the diagnosis and prognosis of LEDVT in aged patients.

关 键 词：同型半胱氨酸 D-二聚体 白介素-18 高敏-C反应蛋白 下肢深静脉血栓形成 

分 类 号：R654.4[医药卫生—外科学]