超声血流参数联合血清D-二聚体和同型半胱氨酸对骨折后下肢深静脉血栓形成的预测效果分析  

Analysis of the Effect of Ultrasound Blood Flow Parameters Combined with Serum D-Dimer and Homocysteine in Predicting Deep Vein Thrombosis of Lower Extrenity after Fracture

作　　者：苏娟 SU Juan(Department of Ultrasonography,Xintai People’s Hospital,Tai’an 271000,China)

机构地区：[1]山东省新泰市人民医院超声科,山东泰安271000

出　　处：《中国伤残医学》2025年第5期86-90,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨超声血流参数联合血清D-二聚体(D-D)、同型半胱氨酸(Hcy)对骨折后下肢深静脉血栓形成(DVT)的预测效果,以期为临床提供更为准确、全面的诊断依据。方法:回顾性分析2023年1月—2024年7月山东省新泰市人民医院收治的81例骨折患者资料。所有患者均接受超声检查以获取血流速度(Vs)、血管内径(Vd)及阻力指数(RI)等参数,并同步进行血清D-D、Hcy水平检测。以临床综合诊断结果作为金标准,采用受试者操作特征(ROC)曲线分析超声血流参数及血清标志物对DVT的诊断效能。此外,对比DVT阳性与阴性组在上述超声参数及血清学指标上的差异。结果:临床综合诊断结果显示,DVT阳性患者29例,DVT阴性患者52例。联合超声血流参数与血清D-D、Hcy的检测,其灵敏度达到0.893,特异度为0.891,AUC为0.899,均高于单独检测方法。DVT阳性组的血清Vs、Vd水平均低于阴性组,而RI高于阴性组,差异均有统计学意义(P<0.05)。同时,DVT阳性组的血清D-D、Hcy水平均高于阴性组,差异均有统计学意义(P<0.05)。结论:超声血流参数联合血清D-D、Hcy检测在预测骨折后下肢DVT形成中具有较高的灵敏度和特异度,优于单独使用超声或血清学指标。这一联合检测方法有助于早期识别下肢DVT高风险患者,为及时干预和治疗提供重要参考。Objective:To explore the prediction effect of ultrasound flow parameters combined with serum D-Dimer(D-D)and homocysteine(Hcy)on deep vein thrombosis(DVT)of lower extremity after fracture,with a view to providing a more accurate and comprehensive diagnostic basis for the clinic.Methods:Data of 81 patients with fracture admitted to the Xintai People’s Hospital between January 2023 and July 2024 were retrospectively analyzed.All patients underwent ultrasonography to obtain parameters such as blood flow velocity(Vs),vessel internal diameter(Vd)and resistance index(RI),and serum D-D and Hcy levels were tested simultaneously.The diagnostic efficacy of ultrasound blood flow parameters and serum markers for DVT formation was analyzed using the receiver operating work characteristic(ROC)curve with the comprehensive clinical diagnosis as the gold standard.In addition,the differences in the above ultrasound parameters and serologic markers between positive and negative DVT formation were compared.Results:The combined clinical diagnosis showed 29 DVT-positive patients and 52 DVT-negative patients.The combined ultrasound blood flow parameters with serum D-D and Hcy had a sensitivity of 0.893,a specificity of 0.891,and an AUC of 0.899,which were higher than those of the individual detection methods.The serum Vs and Vd levels in the DVT formation positive population were significantly lower than those in the negative population,while the RI was higher than that in the negative population,and the differences were statistically significant(P<0.05).Meanwhile,serum D-D and Hcy levels were significantly higher in the DVT formation positive population than in the negative population,and the differences were statistically significant(P<0.05).Conclusion:Ultrasound blood flow parameters combined with serum D-D and Hcy detection have high sensitivity and specificity in predicting DVT of lower extremity after fracture,which is superior to the use of ultrasound or serologic indicators alone.This combined assay can help to identify patie

关 键 词：下肢深静脉血栓 超声血流参数 D-二聚体 同型半胱氨酸 预测效果 骨折 

分 类 号：R683[医药卫生—骨科学]