血清sCD40L、CCL3与多发肋骨骨折患者术后深静脉血栓的相关性  

Correlations of serum sCD40L,CCL3 with postoperative deep vein thrombosis in patients with multiple rib fractures

作　　者：张克诚 李玮 刘英 乔宽宽[4] 李娜[1] 闫菁辉 ZHANG Kecheng;LI Wei;LIU Ying;QIAO Kuankuan;LI Na;YAN Jinghui(Department of Thoracic Surgery,the Fourth People′s Hospital of Hengshui City in Hebei Province,Hengshui,Hebei,053000;Disinfection Supply Room,the Fourth People′s Hospital of Hengshui City in Hebei Province,Hengshui,Hebei,053000;Department of Urology,Harrison International Peace Hospital,Hengshui,Hebei,053000;Department of Neurosurgery,the Fourth People′s Hospital of Hengshui City in Hebei Province,Hengshui,Hebei,053000;Department of Spine Orthopedics,the Fourth People′s Hospital of Hengshui City in Hebei Province,Hengshui,Hebei,053000)

机构地区：[1]河北省衡水市第四人民医院胸外科,河北衡水053000 [2]河北省衡水市第四人民医院消毒供应室,河北衡水053000 [3]哈励逊国际和平医院泌尿科,河北衡水053000 [4]河北省衡水市第四人民医院神经外科,河北衡水053000 [5]河北省衡水市第四人民医院脊柱骨科,河北衡水053000

出　　处：《实用临床医药杂志》2024年第11期58-62,共5页Journal of Clinical Medicine in Practice

基　　金：河北省衡水市科技计划项目(2022014009Z)。

摘　　要：目的探讨多发肋骨骨折患者术后血清可溶性CD40配体(sCD40L)、CC趋化因子配体3(CCL3)水平与其术后深静脉血栓(DVT)的关系。方法选取110例多发肋骨骨折患者作为研究对象,根据术后是否发生DVT分为非DVT组(n=79)和DVT组(n=31)。采用酶联免疫吸附法测定血清sCD40L、CCL3表达水平;采用Pearson相关性分析法分析血清sCD40L、CCL3与凝血功能指标的相关性;采用Logistic回归分析法分析多发肋骨骨折患者术后发生DVT的影响因素;绘制受试者工作特征(ROC)曲线评估血清sCD40L、CCL3对术后DVT的预测价值。结果DVT组的血清sCD40L、CCL3表达水平高于非DVT组,差异有统计学意义(P<0.05)。2组的D-二聚体、凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)比较,差异有统计学意义(P<0.05)。DVT组患者血清sCD40L、CCL3水平与D-二聚体、FIB呈正相关,与PT、TT、APTT呈负相关(P<0.05)。D-二聚体、PT、APTT、FIB、sCD40L、CCL3是多发肋骨骨折患者术后发生DVT的影响因素(P<0.05)。血清sCD40L、CCL3单独预测多发肋骨骨折患者术后DVT的曲线下面积(AUC)分别为0.753、0.754,小于两者联合预测的AUC(0.863),差异有统计学意义(P<0.05)。结论多发肋骨骨折患者术后发生DVT与其血清sCD40L、CCL3高水平有关,两者对术后DVT具有一定的预测价值。Objective To investigate the correlations of postoperative serum levels of soluble CD40 ligand(sCD40L)and CC-chemokine ligand 3(CCL3)with postoperative deep venous thrombosis(DVT)in patients with multiple rib fractures.Methods A total of 110 patients with multiple rib fractures were selected as the study subjects and divided into non-DVT group(n=79)and DVT group(n=31)based on the occurrence of postoperative DVT.Enzyme-linked immunosorbent assay was used to determine the expression levels of serum sCD40L and CCL3.Pearson correlation analysis was employed to analyze the correlations of serum sCD40L,CCL3 with coagulation function indicators.Logistic regression analysis was conducted to identify the influencing factors of postoperative DVT in patients with multiple rib fractures.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of serum sCD40L and CCL3 for postoperative DVT.Results The expression levels of serum sCD40L and CCL3 in the DVT group were significantly higher than those in the non-DVT group(P<0.05).There were statistically significant differences in D-dimer,prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)between the two groups(P<0.05).In the DVT group,serum levels of sCD40L and CCL3 were positively correlated with D-dimer and FIB,and negatively correlated with PT,TT and APTT(P<0.05).D-dimer,PT,APTT,FIB,sCD40L and CCL3 were identified as influencing factors for postoperative DVT in patients with multiple rib fractures(P<0.05).The area under the curve(AUC)of serum sCD40L and CCL3 alone for predicting postoperative DVT in patients with multiple rib fractures was 0.753 and 0.754,respectively,which was significantly smaller than 0.863 of their combined prediction(P<0.05).Conclusion Postoperative DVT in patients with multiple rib fractures is associated with high levels of serum sCD40L and CCL3,which have certain predictive value for postoperative DVT.

关 键 词：多发肋骨骨折 深静脉血栓 可溶性CD40配体 CC趋化因子配体3 

分 类 号：R364.1[医药卫生—病理学] R446.11[医药卫生—基础医学] R274.1