下肢骨折患者术后下肢深静脉血栓的风险因素及IL-6、D-D、TM预测价值分析  

Analysis of risk factors of postoperative lower limb deep venous thrombosis and predictive value of IL-6,D-D and TM in patients with lower limb fractures

作　　者：王灿[1] WANG Can(Department of Clinical Laboratory Medicine,Zhengzhou Orthopaedics Hospital,Henan Zhengzhou 450007)

机构地区：[1]郑州市骨科医院检验科,河南郑州450007

出　　处：《医学检验与临床》2022年第7期24-28,共5页Medical Laboratory Science and Clinics

摘　　要：目的:分析下肢骨折患者术后下肢深静脉血栓(DVT)的风险因素及IL-6、D-D及TM预测价值分析。方法:回顾性分析我院2017年2月~2019年12月期间收治的393例下肢骨折患者资料,统计患者DVT发生情况,对比DVT组和非DVT组基线资料及术前血清白介素-6(L-6)、D-二聚体(D-D)、凝血酶调节蛋白(TM)水平,分析影响骨折患者发生DVT的独立危险因素,并通过ROC曲线分析术前血清IL-6、D-D及TM水平诊断下肢骨折患者发生DVT的价值。结果:393例患者中有86例发生DVT,占比21.88%;两组一般资料中年龄、高血压、骨质疏松、红细胞压积、血小板量、血红蛋白水平、甘油三酯水平、血清IL-6、D-D、TM水平、手术时间、骨折数目比较差异有统计学意义(P<0.05);多因素logistics回归分析显示,年龄、手术时间、血小板量、血清IL-6、D-D、TM是下肢骨折患者术后发生DVT的风险因素(P<0.05);ROC分析发现血清IL-6、D-D、TM单独及联合诊断下肢骨折患者发生DVT的AUC分别为0.882、0.796、0.854和0.948,联合诊断价值更高。结论:年龄、手术时间、血小板量、血清IL-6、D-D.TM水平是下肢骨折患者术后发生下肢深静脉血栓的风险因素(P<0.05),其中血清IL-6、D-D、TM联合预测下肢骨折手术患者发生DVT的价值较高。Objective:To analyze the risk factors of postoperative lower limb deep venous thrombosis(DVT)and predictive value of IL-6,D-D and TM in patients with lower limb fractures.Methods:The data of 393 patients with lower limb fractures admitted to our hospital from February 2017 to December 2019 were retrospectively analyzed.The occurrence of DVT was counted among the patients,and the baseline data and levels of preoperative serum interleukin-6(IL-6),D-dimer(D-D)and thrombomodulin(TM)were compared between DVT group and non-DVT group.The independent risk factors of DVT were identified among patients with fractures,and ROC curve was used to analyze the levels of preoperative serum IL-6,D-D and TM in the diagnosis of DVT in patients with lower limb fractures.Results:86 cases of DVT occurred among 393 patients,accounting for 21.88%.There were statistically significant differences in the age,hypertension,osteoporosis,hematocrit,platelet count,hemoglobin level,triglyceride level,levels of semm IL-6,D-D and TM,surgical time and the number of fractures(P<0.05).Multivariate logistics regression analysis showed that age,surgical time,platelet count,serum IL-6,D-D and TM were the risk factors of occurrence of postoperative DVT inpatients with lower limb fractures(P<0.05).ROC analysis found that the AUC values of single diagnosis and combined diagnosis of serum IL-6,D-D and TM on DVT were 0.882,0.796,0.854 and 0.948 respectively,and the combined diagnosis had higher value.Conclusion:Age,surgical time,platelet count and levels of serum IL-6,D-D and TM are risk factors for lower limb deep venous thrombosis in patients with lower limb fractures(P<0.05).The combination of serum IL-6,D-D and TM has higher value in predicting DVT in patients with lower limb fracture surgery.

关 键 词：下肢深静脉血栓 白介素-6 D-二聚体 凝血酶调节蛋白 

分 类 号：R687.3[医药卫生—骨科学]