血小板参数联合D-二聚体对髋部骨折术后下肢静脉栓塞的预测  

The Prediction of Platelet Parameters Combined with D-dimer for Lower Extremity Venous Thromboembolism After Hip Fracture Surgery

作　　者：吕莹 李成 Lv Ying;Li Cheng(The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000 China)

机构地区：[1]锦州医科大学附属第一医院,辽宁锦州121000

出　　处：《锦州医科大学学报》2024年第3期49-53,共5页Journal of Jinzhou Medical University

基　　金：辽宁省自然科学基金项目,项目编号:201602300。

摘　　要：目的 探讨血小板参数联合血浆D-二聚体对髋部骨折术后下肢静脉栓塞(deep vein thrombosis, DVT)发生风险的预测价值。方法 收集2021年1月1日至2023年9月31日于锦州医科大学附属第一医院骨外科收治的110例髋部骨折患者的临床资料,根据术后有无DVT分为:DVT组34例,无DVT组76例。收集并记录两组患者一般临床资料、血小板计数(platelet count, PLT)、血小板分布宽度(platelet distribution width, PDW)、大血小板比率(platelet-larger cell ratio, P-LCR)及D-二聚体水平,应用SPSS 26.0软件进行统计分析,采用多因素Logistic回归模型分析相关指标与髋部骨折术后DVT发生风险的相关性。绘制ROC曲线,分析血小板参数、D-二聚体及联合因素对髋部骨折术后DVT发生风险的诊断价值,以P<0.05为差异有统计学意义。结果 DVT组患者PLT水平较无DVT组明显降低,差异有统计学意义(P<0.05),DVT组患者P-LCR、PDW及血浆D-二聚体水平较无DVT组明显升高,差异均有统计学意义(P<0.05);以术后是否发生DVT为因变量,以单因素分析中差异有统计学意义的糖尿病病史、D-二聚体、PLT、PDW及P-LCR为自变量,进行二元多因素Logistic回归分析。结果显示D-二聚体、PDW、P-LCR升高及PLT降低均为患者髋部骨折术后DVT发生的独立危险因素,差异均有统计学意义(P<0.05);ROC曲线分析结果显示D-二聚体、PLT、P-LCR及PDW的ROC曲线下面积(AUC)分别为0.703、0.704、0.739和0.704,而联合检测的AUC为0.862,明显高于单一检测。结论 血小板参数及D-二聚体均可作为髋部骨折术后患者发生DVT风险的预测指标,且二者联合诊断价值更高。Objective To investigate the predictive value of platelet parameters in combination with plasma D-dimer levels for assessing the risk of deep vein thrombosis(DVT)following hip fracture surgery.Methods Collection of clinical data was conducted on 110 patients with hip fractures admitted to the Department of Orthopedics at the Third Affiliated Hospital of Jinzhou Medical University from January 1,2021 to September 31,2023.Based on the presence or absence of postoperative DVT,patients were divided into a DVT group(34 cases)and a non-DVT group(76 cases).General clinical data along with platelet count(PLT),platelet distribution width(PDW),platelet-larger cell ratio(P-LCR),and D-dimer levels were collected and recorded for both groups.Statistical analysis was performed using SPSS version 26.0 software.Multivariate Logistic regression model was used to analyze the correlation between relevant indicators and the risk of DVT after hip fracture.ROC curve was drawn to analyze the diagnostic value of platelet parameters,D-dimer and combined factors on the risk of postoperative DVT after hip fracture,with P<0.05 as a statistically significant difference.Results The PLT level in DVT group was significantly lower than that in no DVT group,and the difference was statistically significant(P<0.05)and the P-LCR,PDW and plasma D-dimer levels in DVT group were significantly higher than that in no DVT group,and the differences were statistically significant(P<0.05);the occurrence of postoperative DVT was used as the dependent variable,and the diabetes history,D-dimer,PLT,PDW and P-LCR with statistically significant differences in univariate analysis were used as independent variables.Multivariate logistic regression andysis was performed.The results showed that the increase of D-dimer,PDW and P-LCR and the decrease of PLT were all independent risk factors for DVT after hip fracture,and the differences were statistically significant(P<0.05);ROC curve analysis results showed that the area under ROC curve(AUC)of D-dimer,PLT,P-LCR and PDW

关 键 词：血小板参数 D-二聚体 髋部骨折 静脉血栓 预测 

分 类 号：R683[医药卫生—骨科学]