外周血血小板计数血小板体积分布宽度大血小板比率D-二聚体水平与髋部骨折患者术后深静脉血栓形成的关系分析  

Analysis of the relationship between peripheral blood levels of PLT,PDW,P-LCR,and D-dimer and postoperative DVT formation in patients with hip fracture

作　　者：杨妹音 包梦颖 朱颜鑫 Yang Meiyin;Bao Mengying;Zhu Yanxin(Department of Laboratory,Guizhou Hospital,Beijing Jishuitan Hospital,Guiyang550014,China)

机构地区：[1]北京积水潭医院贵州医院检验科,贵阳550014

出　　处：《山西医药杂志》2025年第7期497-500,共4页Shanxi Medical Journal

摘　　要：目的分析外周血血小板计数(PLT)、血小板体积分布宽度(PDW)、大血小板比率(P-LCR)、D-二聚体水平与髋部骨折患者术后深静脉血栓(DVT)形成的关系。方法选取北京积水潭医院贵州医院检验科2022年6月至2024年6月期间180例因髋部骨折在我院接受手术治疗的患者为研究对象,根据术后是否发生DVT分为DVT组(32例)、非DVT组(148例),比较2组一般临床资料及外周血PLT、PDW、P-LCR、D-二聚体水平,采用Logistic回归模型分析术后DVT发生的独立影响因素,绘制受试者工作特征(ROC)曲线,评估外周血PLT、PDW、P-LCR、D-二聚体水平对髋部骨折术后DVT的预测效能。结果DVT组与非DVT组性别、年龄、骨折病程、骨折部位、手术方式、体质量指数、手术时间、糖尿病史、高血压史差异均无统计学意义(P>0.05);DVT组术前外周血PLT低于非DVT组(P<0.05),PDW、P-LCR、D-二聚体水平均高于非DVT组(P<0.05);Logistic多因素回归分析显示,PLT[OR值(95%CI)=0.978(0.961,0.996)]、PDW[OR值(95%CI)=1.290(1.101,1.512)]、P-LCR[OR值(95%CI)=1.153(1.015,1.309)]、D-二聚体[OR值(95%CI)=3.480(1.646,7.357)]均为髋部骨折术后DVT发生的独立影响因素;ROC曲线分析显示,外周血PLT、PDW、P-LCR、D-二聚体联合预测髋部骨折术后DVT的灵敏度、特异度分别为96.9%、77.7%,对应的曲线下面积(AUC)为0.968。结论外周血PLT、PDW、P-LCR及D-二聚体水平均为髋部骨折术后DVT发生的独立影响因素,联合检测可有效预测DVT的发生,为术后DVT的早期预防和干预提供依据。Objective To analyze the relationship between peripheral blood platelet count(PLT),platelet volume distribution width(PDW),large platelet ratio(P-LCR),and D-dimer level and postoperative deep vein thrombosis(DVT)formation in hip fracture patients.Methods One hundred and eighty patients who underwent surgical treatment for hip fracture at the Laboratory Department of Beijing Jishuitan Hospital Guizhou Branch between June 2022 and June 2024 were selected as the study subjects and were divided into the DVT group(n=32)and the non-DVT group(n=148)according to whether or not DVT occurred in the postoperative period.The two groups were compared with respect to their general clinical data and the levels of peripheral blood PLT,PDW,P-LCR,and D-dimer,and a Logistic regression model was used to analyze the independent influencing factors for the occurrence of postoperative DVT,and plotted the receiver operator characteristic curve(ROC)to assess the predictive efficacy of peripheral blood levels of PLT,PDW,P-LCR,and D-dimer on postoperative DVT after hip fracture.Results There was no statistically significant difference between the DVT and non-DVT groups in terms of gender,age,duration of fracture,fracture site,surgical method,body mass index,duration of surgery,history of diabetes mellitus,and history of hypertension(P>0.05).Preoperative peripheral blood PLT in the DVT group was lower than that in the non-DVT group(P<0.05),and the levels of PDW,P-LCR,and D-dimer were higher than those in the non-DVT group(P<0.05).Logistic multifactorial regression analysis showed that the levels of PLT[OR(95%CI)=0.978(0.961,0.996)],PDW[OR(95%CI)=1.290(1.101,1.512)],P-LCR[OR(95%CI)=1.153(1.015,1.309)],D-dimer[OR(95%CI)=3.480(1.646,7.357)]were all independent influences on the occurrence of DVT after hip fracture.ROC curve analysis showed that the combination of peripheral blood PLT,PDW,P-LCR,and D-dimer had a sensitivity and specificity of 96.9%and 77.7%in predicting DVT after hip fracture,corresponding to an area under the curve(AUC)of 0.96

关 键 词：髋骨折 静脉血栓形成 血小板计数 血小板体积分布宽度 大血小板比率 D-二聚体 

分 类 号：R683.3[医药卫生—骨科学]