血清D-二聚体、血栓素B2联合6-酮-前列腺素F1α对人工膝关节置换术后并发下肢深静脉血栓的预测研究  

Serum D-dimer,thromboxane B2 combined with 6-K-PGF1αprediction of deep vein thrombosis in lower limbs after joint replacement of artificial knee

作　　者：赵允[1] 胡文晋 赵骁虎 王爱国 ZHAO Yun;HU Wen-jin;ZHAO Xiao-hu(Tianjin Institute of Traditional Chinese Medicine Affiliated Hospital,Tianjin 300120,China)

机构地区：[1]天津市中医药研究院附属医院,天津300120

出　　处：《中国中西医结合外科杂志》2024年第5期697-701,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨血清D-二聚体(D-D)、血栓素B2(TXB2)联合6-酮-前列腺素F1α(6-K-PGF1α)对人工全膝关节置换术(TKA)后并发下肢深静脉血栓(DVT)的预测价值。方法:选取拟行TKA的156例患者,根据术后是否并发下肢DVT将其分为并发组(n=52)和非并发组(n=104)。检测并比较两组术前和术后24 h血清D-D、TXB2、6-K-PGF1α水平,采用Logistic回归分析TKA后并发下肢DVT的影响因素,绘制受试者工作特征(ROC)曲线,分析术后24 h血清D-D、TXB2联合6-K-PGF1α对TKA后并发下肢DVT的预测价值。结果:并发组术后24 h血清D-D、TXB2水平均高于非并发组(P<0.05),术后24 h血清6-K-PGF1α水平低于非并发组(P<0.05);Logistic回归分析显示,术后24 h血清D-D、TXB2、6-K-PGF1α水平均是TKA后并发下肢DVT的影响因素(P<0.05);ROC曲线分析显示,血清D-D、TXB2联合6-K-PGF1α预测TKA后并发下肢DVT的灵敏度为94.23%,曲线下面积为0.925,均高于各指标单独预测(P<0.05),特异度与各指标单独预测基本一致。结论:术后24 h血清D-D、TXB2、6-K-PGF1α水平均对TKA后并发下肢DVT具有一定的预测价值,但三者联合的预测价值更高。Objective To explore the predictive value of serum D-dimer(D-D),thromboxane B2(TXB2)combination 6-keto-prostaglandin F1α(6-K-PGF1α)for lower limbs deep vein thrombosis(DVT)after total knee arthroplasty(TKA).Methods 156 patients who plan to undergo TKA were selected,and they were divided into concurrent group and non-concurrent group according to whether postoperative lower limb DVT occurred.The serum levels of D-D,TXB2,6-K-PGF1αbefore and 24 hours after surgery were detected and compared between the two groups.The influencing factors of lower limb DVT after TKA was analyzed by Logistic regression,and the predictive value of the postoperative 24-hour serum D-D,TXB2 and 6-K-PGF1αlevels of DVT in lower limbs after TKA was analyzed by the receiver operating characteristic(ROC)curve.Results The levels of serum D-D and TXB2 in concurrent group at 24 hours after surgery were higher than those in non-concurrent group(P<0.05),and the serum 6-K-PGF1αlevel at 24 hours after surgery was lower than that in non-concurrent group(P<0.05).Logistic regression analysis showed that the levels of serum D-D,TXB2 and 6-K-PGF1αat 24 hours after surgery were the influencing factors for lower limb DVT after TKA(P<0.05).The ROC curve analysis showed that the sensitivity and area under curve of serum D-D,TXB2,and 6-K-PGF1αlevels to predict DVT of lower limbs after TKA were 94.23%and 0.925 respectively,which were higher than the independent prediction of each index(P<0.05),and the specificity was basically consistent with the individual predictions of each indicator.Conclusion The levels of serum D-D,TXB2,6-K-PGF1αat 24 hours after surgery have certain predictive value for lower limb DVT after TKA,but the combined predictive value of the three is higher.

关 键 词：D-二聚体 血栓素B2 6-酮-前列腺素F1Α 人工膝关节置换术 下肢深静脉血栓 

分 类 号：R687.4[医药卫生—骨科学] R691.2[医药卫生—外科学]