D-二聚体、P-选择素及血管内皮生长因子与下肢骨折患者深静脉血栓形成的关系  

The Relationship between D-dimer,P-selectin and Vascular Endothelial Growth Factor and Deep Vein Thrombosis in Patients with Lower Extremity Fracture

作　　者：刘晨 卞泗善[2] 孔鹏[2] 左凯 杜青凤 LIU Chen;BIAN Si-shan;KONG Peng;ZUO Kai;DU Qing-feng(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jin'an,Shandong,250013,China;Department of Minimally Invasive Orthopaedics,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jin'an,Shandong,250011,China)

机构地区：[1]山东中医药大学中医学院,山东济南250013 [2]山东中医药大学附属医院微创骨科,山东济南250011

出　　处：《现代生物医学进展》2021年第15期2926-2930,共5页Progress in Modern Biomedicine

基　　金：山东省医药卫生科技发展计划项目(2015WS0631)。

摘　　要：目的:探究D-二聚体(D-D)、P-选择素及血管内皮生长因子(VEGF)与下肢骨折患者深静脉血栓(DVT)形成的关系。方法:选取2017年2月至2019年10月期间我院诊治的80例下肢骨折并发DVT患者作为DVT组,选择同期治疗的95例下肢骨折但未并发DVT患者作为无DVT组。比较两组患者的各项临床资料,采用多因素Logistic回归分析下肢骨折患者DVT发生的危险因素,采用受试者工作特征(ROC)曲线分析血清D-D、P-选择素、VEGF对下肢骨折患者DVT的诊断价值。结果:与无DVT组相比,DVT组血清D-D、P-选择素和VEGF水平明显升高(P<0.05)。多因素Logistic回归分析结果显示血清D-D、P-选择素、VEGF是下肢骨折患者DVT发生的危险因素(OR=1.996、2.335、1.743,P<0.05)。ROC曲线分析结果显示血清D-D、P-选择素、VEGF诊断下肢骨折患者DVT的曲线下面积(AUC)分别为0.771、0.790、0.812,血清D-D、P-选择素、VEGF联合诊断下肢骨折患者DVT的AUC为0.945。结论:下肢骨折合并DVT患者血清D-D、P-选择素、VEGF水平明显升高,并且血清D-D、P-选择素和VEGF是下肢骨折患者发生DVT的危险因素,三者联合检测在下肢骨折患者发生DVT的诊断和预测中具有一定临床意义。Objective:To explore the relationship between D-dimer(D-D),P-selectin,vascular endothelial growth factor(VEGF)and deep vein thrombosis(DVT)in patients with lower extremity fracture.Methods:80 patients with lower extremity fracture complicated with DVT were selected as DVT group from February 2017 to October 2019,95 patients with lower extremity fracture without DVT who were treated at the same time were selected as non DVT group.The clinical datas between the two groups were compared.The risk factors of DVT in patients with lower extremity fracture were analyzed by multivariate Logistic regression.The diagnostic value of serum D-D,P-selectin and VEGF in patients with lower extremity fracture was analyzed by receiver operating characteristic(ROC)curve.Results:Compared with the non DVT group,the levels of serum D-D,P-selectin and VEGF were significantly increased in DVT group(P<0.05).Multivariate Logistic regression analysis showed that serum D-D,P-selectin and VEGF were risk factors for DVT in patients with lower extremity fracture(OR=1.996,2.335,1.743,P<0.05).The results of ROC curve analysis showed that area under curve(AUC)of serum D-D,P-selectin and VEGF were 0.771,0.790 and 0.812 respectively,the AUC of DVT in patients with lower limb fracture diagnosed by combination of serum D-D,P-selectin and VEGF were 0.945.Conclusion:The levels of serum D-D,P-selectin and VEGF in patients with lower extremity fracture complicated with DVT are significantly increased and serum D-D,P-selectin and VEGF are the main risk factors of DVT in patients with lower extremity fracture.The combined detection of the three has a certain clinical significance in the diagnosis and prediction of DVT in patients with lower extremity fracture.

关 键 词：D-二聚体 P-选择素 血管内皮生长因子 下肢骨折 深静脉血栓 

分 类 号：R683[医药卫生—骨科学]