四肢骨折患者术后血清D-D、sVCAM-1、P-selectin变化及与血栓形成的关系  

Change of serum D-D,sVCAM-1 and P-selectin after limb fractures surgery and their relationship with thrombosis

作　　者：徐标 段玉顺 邱峰 Xu Biao;Duan Yushun;Qiu Feng(Department of Emergency(Trauma)Surgery,Shulan(Hangzhou)Hospital,Hangzhou 310022,China;Department of Emergency,Shulan(Hangzhou)Hospital,Hangzhou 310022,China)

机构地区：[1]树兰(杭州)医院急诊(创伤)外科,杭州310022 [2]树兰(杭州)医院急诊科,杭州310022

出　　处：《中国医师杂志》2023年第3期378-381,共4页Journal of Chinese Physician

摘　　要：目的探究四肢骨折患者术后血清D-二聚体(D-D)、可溶性血管细胞黏附分子1(sVCAM-1)、P-选择素(P-selectin)变化与血栓形成的关系。方法选取2021年1月至2022年1月在树兰(杭州)医院急诊科就诊的289例四肢骨折患者为研究对象,根据术后是否发生深静脉血栓(DVT)分为DVT组(n=62)和非DVT组(n=227),检测所有患者术前术后凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、D-D、sVCAM-1、P-selectin水平。比较DVT组与非DVT组四肢骨折患者PT、APTT、D-D、sVCAM-1、P-selectin水平。Logistic有序逐步回归分析四肢骨折患者术后血栓形成的影响因素。结果289例四肢骨折患者术后的PT、APTT与术前差异无统计学意义(均P>0.05),术后血清D-D、sVCAM-1、P-selectin水平均高于术前(均P<0.05)。DVT组与非DVT组一般资料比较差异无统计学意义(均P>0.05);DVT组术前、术后PT、APTT与非DVT组比较,差异无统计学意义(均P>0.05),DVT组术前、术后血清D-D、sVCAM-1、P-selectin水平均高于非DVT组(均P<0.05)。Logistic有序逐步回归分析结果显示高D-D、sVCAM-1、P-selectin水平是四肢骨折术后血栓形成的危险因素(均P<0.05)。结论四肢骨折术后高D-D、sVCAM-1、P-selectin水平是血栓形成的危险因素。Objective To investigate the relationship between change of serum D-dimer(D-D),soluble vascular cell adhesion molecule 1(sVCAM-1),P-selectin and thrombosis after limb fracture surgery.Methods 289 patients with limb fractures who were treated in the emergency department of Shulan(Hangzhou)Hospital from January 2021 to January 2022 were selected as the study subjects.They were divided into deep vein thrombosis(DVT)group(n=62)and non-DVT group(n=227)according to whether DVT occurred after operation.The levels of prothrombin time(PT),activated partial prothrombin time(APTT),D-D,sVCAM-1 and P-selectin were measured before and after operation in all patients.The levels of PT,APTT,D-D,sVCAM-1 and P-selectin were compared between DVT group and non-DVT group.Logistic sequential stepwise regression analysis was used to analyze the risk factors of postoperative thrombosis in patients with limb fractures.Results There was no statistically significant difference in PT and APTT between 289 patients with limb fractures after operation and before operation(all P>0.05),while the levels of serum D-D,sVCAM-1 and P-selectin after operation were higher than that before operation(all P<0.05).There was no significant difference in general data between DVT group and non-DVT group(all P>0.05);There was no statistically significant difference in PT and APTT before and after operation between DVT group and non-DVT group(all P>0.05).The levels of serum D-D,sVCAM-1 and P-selectin before and after operation in DVT group were higher than those in non-DVT group(all P<0.05).Logistic sequential stepwise regression analysis showed that high levels of D-D,sVCAM-1 and P-selectin were risk factors for thrombosis after limb fracture surgery(all P<0.05).Conclusions High levels of D-D,sVCAM-1 and P-selectin are risk factors for thrombosis after limb fracture surgery.

关 键 词：四肢 骨折 血栓形成 D-二聚体 可溶性血管细胞黏附分子1 P-选择素 

分 类 号：R687.3[医药卫生—骨科学]