Caprini血栓风险模型联合D-二聚体、纤维蛋白单体对老年股骨颈骨折术后下肢深静脉血栓的预测价值  

Predictive value of Caprini thrombosis risk model combined with D-dimer and fibrin monomer for lower extremity deep vein thrombosis after femoral neck fracture in elderly people

作　　者：孙博[1] 王静悦 李冀[1] 蒋雨宸 焦翔[1] 李彬[1] SUN Bo;WANG Jingyue;LI Ji JIANG Yuchen;JIAO Xiang;LI Bin(Department of Trauma three,Tangshan Second Hospital,Tangshan063000,China)

机构地区：[1]河北省唐山市第二医院创伤三科,063000 [2]华北理工大学附属医院神经内科二病区 [3]华北理工大学附属医院骨科病区

出　　处：《中国煤炭工业医学杂志》2023年第4期429-434,共6页Chinese Journal of Coal Industry Medicine

基　　金：河北省医学科学研究课题计划(编号:20201238);唐山市人才资助项目(编号:A20200326)。

摘　　要：目的 探讨Caprini血栓风险模型、D-二聚体、纤维蛋白单体预测老年股骨颈骨折术后并发下肢深静脉血栓(DVT)的临床应用价值。方法 本课题研究对象来自于2020年1月—2022年12月入住唐山市第二医院的老年股骨颈骨折患者,共387例,根据术后超声检查判断是否存在DVT,分为血栓组(128例)及对照组(259例),收集一般资料,比较两组患者Caprini模型评分及D-二聚体(D-D)、纤维蛋白单体水平(FM),并分析Caprini模型评分与D-D、FM水平的相关性,通过绘制ROC曲线评价分析三者单独及联合对老年股骨颈骨折术后发生DVT的预测效能;结果 单因素分析提示:血栓组患者的年龄、LDL-C、手术时长均高于对照组,糖尿病史、既往卒中病史所占比率亦高于对照组;通过多因素logistic回归分析调整混杂因素后提示:Caprini模型评分、D-D、FM均与老年股骨颈骨折术后DVT的发生独立相关;经Pearson相关分析提示:血栓组患者Caprini模型评分与术后D-D、FM水平呈正相关;通过绘制Caprini模型评分、D-D、FM三者单独及联合预测老年股骨颈骨折术后发生DVT的ROC曲线,结果显示三者联合的预测曲线下面积最大,AUC值为0.749,灵敏度、特异度分别为82.81%、74.13%。结论 Caprini模型评分、D-D、FM与老年股骨颈骨折术后DVT密切相关,且三者联合应用对于DVT的发生具有较好的预测效能。Objective To explore the clinical application value of Caprini thrombosis risk model, D-dimer and fibrin monomer in predicting the occurrence of lower extremity deep vein thrombosis(DVT) after femoral neck fracture in the elderly. Methods The research subjects of this project are elderly patients with femoral neck fracture admitted to the Second Hospital of Tangshan from January 2020 to December 2022,a total of 387 cases.According to ultrasound, the presence of DVT was judged, and the study subjects were divided into thrombosis group and control group.And then, general data were collected and the Caprini score and D-dimer(D-D) and fibrin monomer levels(FM) were compared between the two groups.The correlation between Caprini score and D-D and FM levels was analyzed.By plotting ROC curves, the predictive efficacy of the three alone and in combination on the occurrence of DVT after femoral neck fracture in the elderly was evaluated. Results Univariate analysis shows: the age, LDL-C and duration of surgery of patients in the thrombosis group were all higher than those metrics in the control group patients.The rates of diabetes history and previous stroke history were higher than those metrics in the control group, too.After adjusting the confounding factors by multivariate logistic regression analysis, it is suggested that: Caprini score, D-D,and FM were independent risk factors for DVT after femoral neck fracture in the elderly.Prompted by Pearson's correlation analysis: the Caprini score in the thrombosis group was positively correlated with the postoperative D-D and FM levels.The ROC curves of Caprini score, D-D and FM alone and jointly to predict DVT after femoral neck fracture in the elderly were plotted, and the results showed that: The combined prediction curve had the largest area under the curve.Through statistical analysis, the AUC value was 0.749,and the sensitivity and specificity were 82.81% and 74.13%,respectively. Conclusion Caprini score, D-D and FM are closely related to DVT after femoral neck fractu

关 键 词：老年股骨颈骨折 下肢深静脉血栓 Caprini血栓风险模型 D-二聚体 纤维蛋白单体 

分 类 号：R541[医药卫生—心血管疾病]