FIB、NLR联合D-二聚体在TURP后下肢深静脉血栓形成中的临床诊疗价值  

Diagnostic and therapeutic value of FIB,NLR and D-Dimer in DVT after TURP

作　　者：舒辉[1] 王硕 陆攀 SHU Hui;WANG Shuo;LU Pan(Department of Urology,Xiaogan Central Hospital,Xiaogan,Hubei,432000,China;Department of Urology,Postgraduate Training Base of Xiaogan Central Hospital,Jinzhou Medical University)

机构地区：[1]孝感市中心医院泌尿外科,湖北孝感432000 [2]锦州医科大学孝感市中心医院研究生培养基地泌尿外科

出　　处：《临床泌尿外科杂志》2024年第10期894-898,共5页Journal of Clinical Urology

摘　　要：目的:探讨纤维蛋白原(fibrinogen,FIB)和中性粒细胞数/淋巴细胞数比值(neutrophil to lymphocyte ratio,NLR)联合D-二聚体在经尿道前列腺电切术(transurethral resection of the prostate,TURP)后下肢深静脉血栓(deep vein thrombosis,DVT)形成中的临床诊疗价值。方法:选取孝感市中心医院2021年1月—2023年12月接受TURP的患者184例,按照是否发生DVT分为观察组(有DVT,48例)和对照组(无DVT,136例)。收集2组患者的相关临床资料,通过统计学方法分析2组患者FIB、NLR及D-二聚体的表达差异及其临床价值。前瞻性选取20例孝感市中心医院2024年1月—2月预接受TURP的患者,收集并分析其临床指标来进一步增加结果的可信度。结果:2组患者年龄、高血压病史、糖尿病病史比较差异无统计学意义;而吸烟史、NLR、D-二聚体水平及FIB比较差异有统计学意义(P<0.05)。D-二聚体、NLR、FIB均为TURP术后发生DVT的独立危险因素(P<0.05)。NLR与D-二聚体呈正相关,相关系数为0.205,而NLR与FIB、FIB与D-二聚体间无明显相关性(P<0.05)。绘制NLR、FIB、D-二聚体水平受试者工作特征(receiver operating characteristic,ROC)曲线,NLR、FIB、D-二聚体水平的曲线下面积(areas under the curves,AUC)分别为0.707、0.655、0.774,结果可见当D-二聚体单独使用时效果优于NLR、FIB,其截断值为1.125 ng/mL,灵敏度和特异度分别为70.8%、81.6%(P<0.05),而三者联合的预测效果优于其单独使用,AUC为0.837,灵敏度和特异度分别为83.3%和55.1%(P<0.05)。前瞻性分析结果显示术后观察组的患者NLR、D-二聚体水平及FIB与对照组比较差异均有统计学意义(P<0.05)。结论:FIB、NLR、D-二聚体水平均与TURP术后发生DVT有关,若能适当地应用于临床,对高危人群进行早期干预,有希望降低此类人群的术后DVT发生率,在提高患者满意度的同时改善患者预后。Objective To investigate the clinical diagnostic value of patients'fibrinogen(FIB),neutrophil to lymphocyte ratio(NLR)and D-Dimer in deep vein thrombosis(DVT)formation of the lower extremities after transurethral resection of the prostate(TURP).Methods A total of 184 patients who underwent TURP at Xiaogan Central Hospital from January 2021 to December 2023 were selected and divided into an observation group(with DVT,n=48)and a control group(without DVT,n=136)based on the occurrence of DVT.Relevant clinical data were collected from both groups of patients,and statistical methods were used to analyze the expression differences and clinical significance of FIB,NLR,and D-dimer between the two groups.Prospectively,20 patients scheduled to undergo TURP at Xiaogan Central Hospital from January to February 2024 were selected to collect and analyze their clinical indicators,further enhancing the credibility of the results.Results There were no statistically significant differences in age,history of hypertension,or history of diabetes between the two groups of patients;However,statistically significant differences were observed in smoking history,NLR,D-dimer levels,and FIB(P<0.05).D-dimer,NLR,and FIB were identified as independent risk factors for DVT following TURP(P<0.05).NLR was positively correlated with D-dimer,with a correlation coefficient of 0.205,while no significant correlation was found between NLR and FIB,or between FIB and D-dimer(P<0.05).ROC curves were plotted for NLR,FIB,and D-dimer levels,with the AUCs for NLR,FIB,and D-dimer being 0.707,0.655,and 0.774 respectively.The results showed that D-dimer alone was more effective than NLR or FIB,with a cut-off value of 1.125 ng/mL,sensitivity and specificity of 70.8%and 81.6%respectively(P<0.05).The combined prediction of all three factors was superior to their individual use,with an AUC of 0.837,sensitivity of 83.3%,and specificity of 55.1%(P<0.05).Prospective analysis results indicated that there were statistically significant differences in NLR,D-dimer levels,a

关 键 词：纤维蛋白原 中性粒细胞数与淋巴细胞数比值 D-二聚体 经尿道前列腺电切术 下肢深静脉血栓 

分 类 号：R697.3[医药卫生—泌尿科学]