血栓标志物在股骨骨折患者血栓形成中的早期诊断价值  

The early diagnostic value of thrombotic markers in thrombosis formation of patients with femoral fractures

作　　者：郑钦钦 林丽珍 ZHENG Qin-qin;LIN Li-zhen(Department of Laboratory Medicine,Fuzhou Second Ceneral Hospital,Fuzhou 350007,China)

机构地区：[1]福州市第二总医院检验科,350007

出　　处：《中国现代药物应用》2025年第2期59-62,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 分析血栓标志物与股骨骨折患者血栓形成的关系,为股骨骨折患者血栓形成的预防及早期诊断提供依据。方法 选取132例股骨骨折患者为研究对象,根据术后是否并发深静脉血栓形成(DVT)分为DVT组(55例)和非DVT组(77例)。比较两组一般资料,血栓标志物[凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α_(2)纤溶酶抑制物复合物(PIC)、血栓调节蛋白(TM)、组织型纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物(t-PAIC)、D-二聚体(D-D)]水平,分析血栓标志物单独检测及联合检测对股骨骨折血栓形成的诊断效能。结果 DVT组患者的年龄、女性占比大于非DVT组,差异具有统计学意义(P<0.05)。DVT组患者的TAT(26.398±23.132)ng/ml、PIC(2.246±1.481)μg/ml、D-D(13.293±14.794)mg/L均高于非DVT组的(11.080±6.868)ng/ml、(1.207±0.594)μg/ml、(2.855±1.943)mg/L,差异具有统计学意义(P<0.05)。两组TM、t-PAIC比较,差异无统计学意义(P>0.05)。单独检测时以D-D对股骨骨折血栓形成的诊断效能最高,约登指数最大时对应最佳截断值为5.085 mg/L,曲线下面积(AUC)为0.896,敏感度、特异度分别为0.764、0.857。联合检测时以TAT+PIC+D-D对股骨骨折血栓形成的诊断效能最高,AUC为0.924,敏感度、特异度分别为0.909、0.766。结论 股骨骨折术前,TAT、PIC、D-D联合检测可提高患者血栓形成的诊断效能,可为临床股骨骨折患者血栓形成早期预警提供诊断依据。Objective To analyze the relationship between thrombotic markers and thrombosis in patients with femoral fracture,and to provide evidence for the prevention and early diagnosis of thrombosis in patients with femoral fracture.Methods 132 patients with femoral fracture were selected and divided into deep vein thrombosis (DVT) group (55 cases) and non-DVT group (77 cases) according to whether there was DVT formation after operation.Patients in both groups were compared in terms of general data,thrombotic markers[thrombin antithrombin complex (TAT),plasmin-α_(2) plasmin inhibitor complex (PIC),thrombomodulin (TM),tissue plasminogen activator-inhibitor complex (t-PAIC),D-dimer (D-D)].The diagnostic efficiency of single and combined detection of thrombotic markers for thrombosis formation was analyzed.Results The age and proportion of female in DVT group was higher than those in non-DVT group,and the difference was statistically significant(P<0.05).DVT group had TAT of (26.398±23.132) ng/ml,PIC of (2.246±1.481)μg/ml,and D-D of (13.293±14.794) mg/L,which were higher than (11.080±6.868) ng/ml,(1.207±0.594)μg/ml and (2.855±1.943) mg/L in non-DVT group,and the differences were statistically significant (P<0.05).There was no significant difference in TM and t-PAIC between the two groups (P>0.05).D-D had the highest diagnostic efficiency for thrombosis formation,with the optimal cutoff value corresponding to the maximum Youden's index of 5.085 mg/L,an area under the curve (AUC) of 0.896,a sensitivity of 0.764 and specificity of 0.857.In the combined detection,TAT+PIC+D-D had the highest diagnostic efficiency for thrombosis formation,with an AUC of 0.924,a sensitivity of 0.909 and a specificity of 0.766.Conclusion Combined detection of TAT,PIC and D-D before femoral fracture surgery can improve the diagnostic efficiency for thrombosis formation in patients,thus providing diagnostic evidence for early warning of thrombosis in femoral fracture patients.

关 键 词：股骨骨折 血栓标志物 D-二聚体 血栓形成 早期诊断 

分 类 号：R683.42[医药卫生—骨科学]