血清同型半胱氨酸、叶酸、抗凝血酶Ⅲ在髂总静脉狭窄合并下肢深静脉血栓中的应用价值  

Serum homocysteine,folic acid,antithrombinⅢin common iliac vein stricture combined value of deep vein formation

作　　者：迟国庆[1] 王斌[1] 史瑞娜[1] 宋文杰 CHI Guo-qing;WANG Bin;SONG Wen-jie(Aerospace Center Hospital,Department of Interventional Radiology and Vascular Surgery,Beijing 100049,China)

机构地区：[1]航天中心医院外周血管介入科,北京100049

出　　处：《中国实验诊断学》2020年第8期1259-1263,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨血清同型半胱氨酸、叶酸及抗凝血酶Ⅲ在髂总静脉狭窄合并下肢深静脉形成患者中的应用价值。方法选取2017年1月-2019年1月收治的髂总静脉狭窄患者120例,根据病人是否存在下肢深静脉血栓分为DVT组(n=60)和无DVT组(n=60),检测血中同型半胱氨酸、叶酸、抗凝血酶Ⅲ的水平,分析三者之间的相关性,应用受试者工作特征曲线(ROC)分析血中同型半胱氨酸、叶酸、抗凝血酶Ⅲ水平在髂静脉狭窄合并下肢深血栓形成中的诊断价值。结果髂总静脉狭窄合并DVT组的同型半胱氨酸水平高于无DVT组,叶酸、抗凝血酶Ⅲ水平低于无DVT组,两组比较有统计学差异(P<0.05)。同型半胱氨酸水平与叶酸、抗凝血酶Ⅲ呈负相关,相关性有统计学意义(P<0.01)。在ROC曲线分析中,同型半胱氨酸在合并DVT诊断中的ROC曲线下面积为0.800,界值取14.00μmol/L时,诊断敏感度和特异度分别为83.3%、76.7%。叶酸在合并DVT诊断中的ROC曲线下面积为0.735,界值取8.17mmol/L时,诊断敏感度和特异度分别为75.0%、81.7%。抗凝血酶Ⅲ在下肢静脉血栓中的诊断中的ROC曲线下面积为0.799,界值取79.0%时,诊断敏感度和特异度分别为81.7%、80.0%。三者联合诊断下肢静脉血栓时ROC曲线下面积为0.882,诊断敏感度和特异度分别为:98.3%和75.0%。联合检测分别与同型半胱氨酸、叶酸、抗凝血酶Ⅲ比较的面积差异为0.082、0.146和0.082,差异有统计学意义(P<0.01)。结论血清同型半胱氨酸、叶酸、抗凝血酶Ⅲ水平可作为评估患者髂总静脉狭窄发生下肢深静脉血栓的重要指标,联合检测可提高诊断能力,在DVT的早期筛查中有重要诊断价值。Objective To investigate the value of serum homocysteine,folic acid and antithrombinⅢin patients with common iliac vein stenosis and deep vein formation.Methods Selected from January 2017 to January 2019 were common iliac vein stricture of 120 cases of patients,according to the presence of deep vein formation patients were divided into DVT group(n=60)and no DVT(n=60),detection of blood homocysteine,folic acid,antithrombinⅢlevel,analysis the correlation between the three,the receiver-operating characteristic curve(ROC)is used to analyze blood homocysteine,folic acid,anti-thrombinⅢlevels in iliac vein stricture combined diagnostic value in deep vein formation.Results Common iliac vein stricture combined DVT group of homocysteine levels higher than that of group without DVT,folic acid,antithrombinⅢlevels below no DVT group,two groups are statistically significant(P<0.05).Homocysteine levels and folic acid,antithrombinⅢshowed a negative correlation,the correlation was statistically significant(P<0.01).In the ROC curve analysis,the area under the ROC curve of homocysteine in the diagnosis of DVT was0.800,and the diagnostic sensitivity and specificity were 83.3%and 76.7%,when the threshold value was 14.00 mol/L.The area under ROC curve of folic acid in the diagnosis of DVT was 0.735,and the diagnostic sensitivity and specificity were 75.0%and 81.7%,when the cut-off value was 8.17 mmol/L.AntithrombinⅢin the diagnosis of lower limb venous thrombosis in the area under the ROC curve is 0.799,boundary value 79.0%,the diagnostic sensitivity and speciality rate were 81.7%,80.0%.When the area under ROC curve was 0.882,the diagnostic sensitivity and specificity were 98.3%and 75.0%.Joint inspection and check the homocysteine,folic acid,antithrombinⅢarea difference is0.082,0.146 and 0.082,the difference was statistically significant(P<0.01).Conclusion Serum homocysteine,folic acid,antithrombin III levels can be used as evaluation in patients with common iliac Vein of deep venous thrombosis.Combined detection can imp

关 键 词：同型半胱氨酸 叶酸 抗凝血酶Ⅲ 髂总静脉狭窄 下肢深静脉血栓形成 

分 类 号：R543.6[医药卫生—心血管疾病]