纤维蛋白原、纤维蛋白单体对下肢骨折患儿术后发生深静脉血栓的预测价值  

Predictive value of fibrinogen and fibrin monomer on postoperative deep vein thrombosis in children with lower extremity fracture

作　　者：邓勇 胡泽容 王平康[1] 母德安 Deng Yong;Hu Zerong;Wang Pingkang;Mu De'an(Department of Pediatrics,Jianyang People's Hospital,Jianyang 641400,Sichuan,China;Department of Neonatology,Jianyang People's Hospital,Jianyang 641400,Sichuan,China;Department of Pediatric General Surgery,Jianyang People's Hospital,Jianyang 641400,Sichuan,China)

机构地区：[1]简阳市人民医院儿科,四川简阳641400 [2]简阳市人民医院新生儿科,四川简阳641400 [3]简阳市人民医院小儿普外科,四川简阳641400

出　　处：《血管与腔内血管外科杂志》2022年第11期1397-1400,共4页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨纤维蛋白原(FIB)、纤维蛋白单体(FM)对下肢骨折患儿术后发生深静脉血栓(DVT)的预测价值。方法收集2019年1月至2021年12月简阳市人民医院收治的80例下肢骨折患儿的临床资料,根据术后是否发生下肢DVT分为观察组(n=10,术后发生下肢DVT)和对照组(n=70,术后未发生下肢DVT)。记录并比较两组患儿的血流滞缓率及血清纤维蛋白原(FIB)、纤维蛋白单体(FM)水平。采用受试者工作特征(ROC)曲线分析FIB、FM单独及联合检测对下肢骨折患儿术后发生DVT的预测价值。结果下肢静脉彩色多普勒超声检查结果显示,两组患儿的血流滞缓率比较,差异无统计学意义(P>0.05)。术后1、7 d,观察组患儿的血清FIB水平均明显高于对照组患儿,差异均有统计学意义(P<0.01)。ROC曲线分析结果显示,FIB、FM联合检测预测下肢骨折患儿术后发生DVT的ROC曲线下面积最大[0.821(95%CI:0.694~0.948)],特异度最高(87.60%)。结论FIB、FM可作为预测下肢骨折患儿术后发生DVT的重要指标,其水平升高提示存在继发DVT的风险,二者联合检测对早期DVT具有较高的预测价值。Objective To investigate the predictive value of fibrinogen(FIB)and fibrin monomer(FM)for postoperative deep vein thrombosis(DVT)in children with lower extremity fracture.Method The clinical data of 80children with lower extremity fracture admitted to Jianyang People’s Hospital from January 2019 to December 2021were collected.According to whether lower extremity DVT occurred after the operation,the two groups were divided into observation group(n=10,lower extremity DVT occurred after the operation)and control group(n=70,lower extremity DVT did not occur after the operation).The rate of blood flow sluggishness and the levels of fibrinogen(FIB)and fibrin monomer(FM)in serum were recorded and compared between the two groups.The predictive value of FIB,FM alone,and combined detection for postoperative DVT in children with lower extremity fracture were also analyzed by receiver operating characteristic(ROC)curve.Result The results of color Doppler ultrasonography of lower extremity veins showed that there were no significant differences in the rate of blood flow sluggishness between the two groups(P<0.05).On 1 and 7 days after the operation,the serum FIB levels of children in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.01).The results of the ROC curve analysis showed that the area under the curve of the combined detection of the two indicators in predicting postoperative DVT in children with lower extremity fracture was the largest[0.821(95%CI:0.694-0.948)],and the specificity was the highest(87.60%).Conclusion FIB and FM could be used as important indicators to predict postoperative DVT in children with lower extremity fractures,and their elevated levels indicate the risk of secondary DVT.The combined detection of the two indicators has a high predictive value for early DVT.

关 键 词：纤维蛋白原 纤维蛋白单体 下肢骨折 深静脉血栓 预测价值 

分 类 号：R543[医药卫生—心血管疾病]