剪切波超声弹性成像定量评估比目鱼肌硬度对下肢远端深静脉血栓短期进展的预测价值  

Predictive value of quantitative evaluation of shear wave ultrasound elastography on the hardness of soleus muscle for shortterm progress of distal deep venous thrombosis of lower extremities

作　　者：李玉芳 穆桂瑶 许琨 马利菊 Li Yufang;Mu Guiyao;Xu Kun;Ma Liju(Department of Function,The Second Hospital of Zhangjiakou,Zhangjiakou 075000,China;Department of Function,The Fourth Hospital of Zhangjiakou,Zhangjiakou 075000,China;Laborotary,The First Hospital of Zhangjiakou,Zhangjiakou,China)

机构地区：[1]张家口市第二医院功能科,张家口075000 [2]张家口市第四医院功能科,张家口075000 [3]张家口市第一医院体检科,张家口075000

出　　处：《中国医学装备》2025年第3期58-62,共5页China Medical Equipment

基　　金：河北省医学科学研究课题(20232065)。

摘　　要：目的:探讨剪切波超声弹性成像(SWUE)定量评估比目鱼肌硬度对下肢远端深静脉血栓(DVT)短期进展的预测价值。方法:回顾性选取2021年1月至2023年12月期间张家口市第二医院收治的100例DVT患者,按照确诊后2周的下肢血管超声复查结果将其分为进展组(45例)和非进展组(55例),采用单因素、多因素logistics回归分析DVT患者短期进展影响因素,绘制受试者工作特征(ROC)曲线,分析SWUE定量评估比目鱼肌硬度在预测DVT患者短期进展中的应用价值,比较两组患者治疗前后的凝血指标。结果:两组患者胆固醇、中性粒细胞、血小板计数、中心静脉置管、卧床制动、血栓史及血管壁损伤以及下肢外科手术史比较,差异无统计学意义(P>0.05)。进展组患者比目鱼肌平均硬度(6.46±1.15)kPa,非进展组患者比目鱼肌平均硬度(5.42±1.13)kPa,两组比较差异有统计学意义(t=4.542,P<0.05),多因素logistics回归分析结果显示,比目鱼肌硬度是DVT患者短期进展的独立影响因素(OR=3.135,P<0.05),ROC曲线分析结果显示,比目鱼肌硬度对DVT患者短期进展的预测曲线下面积为0.9074(95%CI:0.8175~0.9972),最佳截断值为0.70,此时灵敏度为78.26%,特异度为91.30%。治疗前两组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及D-二聚体(D-dimer)比较差异无统计学意义(P>0.05),治疗后非进展组患者的PT、APTT及TT水平均高于进展组患者,D-dimer低于进展组患者,两组比较差异有统计学意义(t=3.568、15.176、4.091、9.981,P<0.05)。结论:SWUE定量评估比目鱼肌硬度在下肢远端深静脉血栓短期进展中有较好的预测价值,有助于早期发现DVT的短期进展,从而及时采取干预措施,降低并发症的风险,改善患者预后。Objective:To explore predictive value of quantitative evaluation of shear wave ultrasonic elastography(SWUE)on the hardness of soleus muscle for short-term progress of the distal deep venous thrombosis(DVT)of lower extremities.Methods:A total of 100 DVT patients who admitted to the second hospital of Zhangjiakou from January 2021 to December 2023 were retrospectively selected,and they were divided into group with progress(n=45)and group without progress(n=55)according to the results of the ultrasonic reexamination of blood vessels of lower extremities at the 2nd week after they were confirmed.Univariate and multivariate logistics regression analysis were used to analyze the influencing factors for short-term progress of DVT patients.Receiver operating characteristic(ROC)curve was drawn to analyze the applied value of SWUE quantitative assessment for the hardness of soleus muscle in predicting the short-term progress of DVT patients.The coagulation indicators of the two groups before and after treatment were further compared.Results:There were no significant differences between the two groups in cholesterol,neutrophil count,platelet count,central venous catheterization,bed rest,history of thrombosis,injury of vascular wall,and history of surgery for lower limb(P>0.05).The average hardness values of soleus muscle of group with progress and group without progress were respectively(6.46±1.15)kPa and(5.42±1.13)kPa,and the difference of that between two groups was significant(t=4.542,P<0.05).Multivariate logistics regression analysis showed that hardness of soleus muscle was the independent risk factor for short-term progress of DVT patients(OR=3.135,P<0.05).The results of ROC analysis showed that the area under curve(AUC)value of the hardness of soleus muscle in predicting short-term progress of DVT patients was 0.9074(95%CI:0.8175~0.9972),and the best cutoff value was 0.70,and the sensitivity and the specificity were respectively 78.26%and 91.30%at this time.Before treatment,there were no significant differences in

关 键 词：剪切波超声弹性成像(SWUE) 比目鱼肌硬度 下肢远端深静脉血栓 预测价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]