血栓弹力图与凝血因子Ⅴ、Serpine1对创伤性骨折患者术后下肢深静脉血栓的预测价值分析  

Predictive value of thrombelastography,coagulation factorⅤand Serpine1 for postoperative deep vein thrombosis in lower extremities in patients with traumatic fractures

作　　者：王娜[1] 叶兰 杨正东 张国君[1] WANG Na;YE Lan;YANG Zhengdong;ZHANG Guojun(Department of Laboratory Medicine,Hangzhou Plastic Surgery Hospital,Hangzhou 310014,Zhejiang,China;Ultrasound Room,Hangzhou Plastic Surgery Hospital,Hangzhou 310014,Zhejiang,China;Department of Laboratory Medicine,the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310005,Zhejiang,China)

机构地区：[1]杭州整形医院检验科,浙江杭州310014 [2]杭州整形医院B超室,浙江杭州310014 [3]浙江中医药大学附属第三医院检验科,浙江杭州310005

出　　处：《中国现代医生》2023年第3期28-31,50,共5页China Modern Doctor

摘　　要：目的探讨血栓弹力图(thrombelastography,TEG)与人纤溶酶原激活物抑制剂1(human plasminogen activator inhibitor-1,Serpine1)对创伤性骨折患者术后下肢深静脉血栓的预测价值。方法选取2019年10月至2021年10月于杭州整形医院就诊的疑似下肢深静脉血栓的创伤性骨折术后患者272例,以超声造影检查诊断为“金标准”,将确诊为下肢深静脉血栓的200例患者设为研究组,72例非下肢深静脉血栓患者设为对照组,两组患者均行TEG检查,检测两组的凝血因子Ⅴ、Serpine1水平。结果与对照组比较,研究组的TEG参数凝固时间(solidification time,K)、反应时间(reaction time,R)降低,最大幅度(maximum magnitude,MA)、凝固角(solidification angle,α)升高,且研究组重度患者的K、R较低,MA、α、凝血因子Ⅴ、Serpine1水平较高(P<0.05)。K、R、MA、α、凝血因子Ⅴ、Serpine1与研究组轻度、重度严重程度相关,且K、R、MA、α与凝血因子Ⅴ、Serpine1相关。K、R、MA、α、凝血因子Ⅴ、Serpine1联合检测对创伤性骨折患者术后下肢深静脉血栓的预测价值较高。结论TEG联合凝血因子Ⅴ、Serpine1对创伤性骨折患者术后下肢深静脉血栓有较高的预测价值,具有一定的临床价值。Objective To investigate the predictive value of thrombolography and human plasminogen activator inhibitor-1(Serpine1)for postoperative deep vein thrombosis of lower extremity in patients with traumatic fractures.Methods A total of 272 patients with traumatic fracture who were treated in Hangzhou Plastic Surgery Hospital from October 2019 to October 2021 and suspected to had deep venous thrombosis of lower extremities were selected.Used contrast-enhanced ultrasound diagnosis as the"gold standard",200 patients diagnosed with deep venous thrombosis of lower extremities were set as the study group and 72 patients without deep venous thrombosis of lower extremities were set as the control group.Thrombologram was performed in both groups to detect the levels of coagulation factor V and Serpine1.Results Compared with the control group,the parameters of thrombologram in the study group were as follows:solidification time K and reaction time R decreased,maximum magnitude MA andαincreased,and the K and R of severe patients in the study group were low.The levels of MA,α,coagulation factor V and Serpine1 were higher(P<0.05).K,R,MA,α,coagulation factor V and Serpine1 were correlated with mild and severe severity in the study group,and K,R,MA andαwere correlated with coagulation factor V and Serpine1.The combined detection of K,R,MA,α,clotting factor V and Serpine1 has high predictive value for postoperative deep venous thrombosis of lower extremity in patients with traumatic fractures.Conclusion Thrombolography combined with coagulation factor V and Serpine1 has a high predictive value for postoperative deep venous thrombosis of lower limbs in patients with traumatic fractures,and has certain clinical value.

关 键 词：创伤性骨折 下肢深静脉血栓 血栓弹力图 凝血因子Ⅴ 纤溶酶原激活物抑制剂1 

分 类 号：R651.15[医药卫生—外科学]