血清白细胞表面分化抗原40配体联合Wells评分对产褥期深静脉血栓的诊断价值及其与凝血、血小板功能及炎症指标的相关性  

The diagnostic value of serum CD40L combined with Wells score for postpartum deep venous thrombosis and its correlation with coagulation,platelet function,and inflammation indicators

作　　者：肖飞 张丽珍 李萍 刘晓娟 Xiao Fei;Zhang Lizhen;Li Ping;Liu Xiaojuan(Nutrition Department,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao 066000,Hebei,China;Department of Gynaecology and Obstetrics,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao 066000,Hebei,China;Nutrition Department,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China;Endocrinology Department,Qinhuangdao Maternal and Child Health Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市妇幼保健院营养科,河北秦皇岛066000 [2]秦皇岛市妇幼保健院妇产科,河北秦皇岛066000 [3]秦皇岛市第一医院营养科,河北秦皇岛066000 [4]秦皇岛市妇幼保健院内分泌科,河北秦皇岛066000

出　　处：《中国医学前沿杂志（电子版）》2024年第5期30-35,共6页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：秦皇岛市科学技术研究与发展计划项目(202301A197)。

摘　　要：目的探讨血清白细胞表面分化抗原40配体(CD40 ligand,CD40L)联合Wells评分对产褥期深静脉血栓(deep vein thrombosis,DVT)的诊断价值及其与凝血、血小板功能及炎症指标的相关性。方法选取2013年8月至2023年7月秦皇岛市妇幼保健院收治的107例产褥期DVT患者作为研究对象,设为DVT组。选取同期在秦皇岛市妇幼保健院分娩的健康产妇100例作为对照组。比较两组基本资料、血清CD40L、Wells评分及凝血、血小板功能及炎症指标,进行Pearson相关性分析,并采用受试者操作特征(receiver operating characteristic,ROC)曲线评价CD40L、Wells评分对产褥期DVT的诊断价值。结果两组研究对象的基本资料差异无统计学意义(均P>0.05)。相比于对照组,DVT组血清CD40L、Wells评分、凝血指标[D-二聚体(D-dimer,D-D)、纤维蛋白原(fibrinogen,FIB)]、血小板功能指标[血小板黏附率(platelet adhesion rate,PAdT)、血小板聚集率(platelet aggregation rate,PAgT)、P选择素(P-selection)]、炎症因子[白细胞介素-6(interleukin-6,IL-6)/IL-1β、高敏C反应蛋白(high-sensitivity c-reactive protein,hs-CRP)]更高(P<0.05),凝血指标(凝血酶原活化时间、凝血酶原时间)更低(P<0.05)。经过Pearson相关性分析,D-D、FIB、PAdT、PAgT、P-selection、IL-6、IL-1β、hs-CRP与产褥期VTE患者血清CD40L、Wells评分均呈正相关(P<0.05),APTT、PT与血清CD40L、Wells评分呈负相关(P<0.05)。ROC曲线显示,血清CD40L联合Wells评分诊断产褥期DVT的AUC、敏感度均显著高于各指标单独诊断(P<0.05)。结论血清CD40L联合Wells评分可提高产褥期DVT的诊断效能,有利于疾病的早期确诊,并及时采取治疗措施。Objective To investigate the diagnostic value of serum CD40L combined with Wells score for postpartum deep vein thrombosis(DVT)and its correlation with coagulation,platelet function,and inflammatory indicators.Methods A total of 107 patients with postpartum DVT admitted to Qinhuangdao Maternal and Child Health Hospital from August 2013 to July 2023 were selected as the study subjects and assigned to the DVT group.100 healthy postpartum women who delivered in the same hospital during the same period were selected as the control group.Basic data,serum CD40L,Wells scores,coagulation,platelet function,and inflammation indicators were compared between two groups.Pearson correlation analysiswas uese.The diagnostic value of CD40L and Wells scores for the dignosis of postpartum DVT was evaluated by using receiver operating characteristic(ROC)curves.Results There was no statistical difference in the basic data between the two groups of study subjects(P>0.05).Compared to the control group,the serum CD40L,Wells score,coagulation indicators(D-D,FIB),platelet function indicators(PAdT,PAgT,P-selection),and inflammatory factors(IL-6,IL-1β),hs-CRP were in DVT group are higher(P<0.05),while coagulation indicators(APTT,PT)are lower(P<0.05).After Pearson correlation analysis,D-D,FIB,PAdT,PAgT,P-selection,IL-6,IL-1β,hs-CRP were positively correlated with serum CD40L and Wells scores in postpartum VTE patients(P<0.05),while APTT and PT were negatively correlated with serum CD40L and Wells scores(P<0.05).The ROC curve showed that the AUC and sensitivity of serum CD40L combined with Wells score in diagnosing postpartum DVT were significantly higher than any single indicators(P<0.05).Conclusions The combination of serum CD40L and Wells score can improve the diagnostic efficacy of postpartum DVT,which are helpful for early diagnosis of the disease and timely treatment measures.

关 键 词：白细胞表面分化抗原40配体 WELLS评分 产褥期深静脉血栓 诊断价值 

分 类 号：R47[医药卫生—护理学]