下肢静脉血栓患者D-二聚体水平动态分析与治疗后超声特征的相关性  

Correlation between the dynamic analysis of D-dimer levels and post-treatment ultrasonic characteristics in patients with venous thrombosis of lower limbs

作　　者：蒋俊杰[1] 盛晨威 JIANG Junjie;SHENG Chenwei(Department of Special inspection Division,Huzhou Third People's Hospital,Huzhou,Zhejiang 313000,China;不详)

机构地区：[1]湖州市第三人民医院特检科,浙江湖州313000 [2]湖州市第一人民医院超声科,浙江湖州313000

出　　处：《中华全科医学》2025年第1期111-114,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2021KY1098)。

摘　　要：目的检测下肢静脉血栓患者的D-二聚体水平,并分析患者治疗后的超声特征与D-二聚体水平动态变化间的关系。方法回顾性选取2020年6月—2022年3月于湖州市第三人民医院接受抗凝治疗的127例下肢深静脉血栓患者作为研究对象,记录患者治疗前后的D-二聚体水平,根据随访过程中的下肢静脉血栓栓塞复发情况,将患者分为复发组和未复发组,分析D-二聚体水平动态变化与治疗后超声特征的相关性和复发风险时间点。结果随访过程中共34例患者发生下肢静脉血栓栓塞复发情况纳入复发组,其余93例患者纳入非复发组。复发组的股静脉[FV,(8.53±1.51)cm/s]等超声血流信号值均低于未复发组[(19.79±5.29)cm/s,t=12.231,P<0.001];治疗6个月后的D-二聚体水平与FV(r=-0.499,P<0.001)、肌间静脉(CIV,r=-0.588,P<0.001)、腘静脉(POV,r=-0.538,P<0.001)的超声血流信号值均呈负相关关系;治疗6、9、12个月后的D-二聚体水平对下肢静脉血栓栓塞的复发风险有影响,差异有统计学意义(P<0.05)。结论D-二聚体水平动态变化可监测下肢静脉血栓患者抗凝治疗后的复发风险,在抗凝治疗3个月后应开始注意患者D-二聚体水平的异常升高,延长患者的抗凝治疗时间,以防止下肢静脉血栓的复发。Objective To detect the level of D-dimer in patients with venous thrombosis of lower limbs and analyze the relationship between the ultrasonic characteristics of patients after treatment and the dynamic changes in D-dimer level.Methods One hundred and twenty-seven patients with deep venous thrombosis of lower limbs who received anticoagulant therapy at the Huzhou Third People's Hospital from June 2020 to March 2022 were selected retrospectively.D-dimer levels were recorded before and after treatment.According to the recurrence of venous thromboembolism in lower limbs during follow-up,patients were divided into a recurrence group and a non-recurrence group.The correlation between the dynamic changes in D-dimer levels,the ultrasonic characteristics after treatment,and the time point of recurrence risk was analyzed.Results Of the 127 patients,34 were included in the recurrence group,and the remaining 93 patients were included in the non-recurrence group.FV[(8.53±1.51)cm/s]and other ultrasonic blood flow signal values in the recurrence group were lower than those in the non-recurrence group[(19.79±5.29)cm/s,t=12.231,P<0.001].Six months after treatment,D-dimer levels were negatively correlated with the ultrasonic blood flow signal values of FV(r=-0.499,P<0.001),CIV(r=-0.588,P<0.001),and POV(r=-0.538,P<0.001).The differences in D-dimer levels at 6,9,and 12 months after treatment had statistical significances for the recurrence risk of venous thromboembolism in lower limbs(P<0.05).Conclusion The dynamic changes of D-dimer levels can monitor the recurrence risk in patients with venous thrombosis of lower limbs after anticoagulation treatment.After 3 months of anticoagulation treatment,monitoring for abnormal increase in D-dimer levels is crucial,and extending the duration of anticoagulation treatment may help prevent the recurrence of lower-limb venous thrombosis.

关 键 词：下肢静脉血栓 D-二聚体 动态分析 骨折 抗凝治疗 彩色多普勒超声 

分 类 号：R543.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]