Caprini评分、D-二聚体、纤维蛋白原水平在骨折后下肢深静脉血栓病人中的变化及其临床意义

doi:10.3969/j.issn.1005-6483.2019.04.018

摘要/Abstract

摘要： 目的探讨Caprini评分、血浆D-二聚体（D-D）、纤维蛋白原（FIB）水平在骨折后下肢深静脉血栓（DVT）病人中的变化及其临床意义。方法骨折后DVT病人60例（DVT组），骨折后未发生DVT的病人120例（对照组），对比两组病人的Caprini评分、血浆D-二聚体（D-D）、纤维蛋白原（FIB）水平，分析Caprini评分与DVT组病人的血浆D-D、FIB的关系。结果 DVT组病人的Caprini评分（7.26±1.88）分、D-D（3.31±1.52）mg/L、FIB（4.48±0.72）g/L，对照组分别为（3.39±0.80）分、（0.46±0.11）mg/L、（3.60±0.68）g/L，两组比较差异具有统计学意义（P<0.05）；DVT组病人的Caprini评分与D-D、FIB水平均呈正相关（r=0.748、r=0.662，P<0.05）；Wells评分与D-D、FIB水平三者联合应用鉴别诊断骨折病人发生DVT的灵敏度为97.83%、特异度为92.00%、漏诊率为2.17%、误诊率为8.00，ROC曲线下面积AUC值为0.947（P<0.05）。结论下肢骨折病人的Caprini评分、D-D、FIB水平对于诊断DVT具有一定的临床价值。

关键词: Caprini评分, D-二聚体, 纤维蛋白原, 骨折, 下肢深静脉血栓

Abstract:

Objective To investigate the changes of Caprini score，plasma D-D and FIB levels in patients with post-fracture DVT and its diagnostic significance.Methods Sixty patients with postfracture DVT（DVT group）and 120 patients without DVT after fracture were selected（control group）.The Caprini score，plasma D-D and FIB levels were compared between the two groups.The relationship between Caprini score and plasma D-D and FIB in the DVT group was analyzed.Results The Caprini score，D-D and FIB levels in the DVT group[7.26±1.88，（3.31±1.52）mg/L，（4.48±0.72）g/L] were significantly higher than those in the control group[3.39±0.80，（0.46±0.11）mg/L，（3.60±0.68）g/L]，and the difference was statistically significant（P<0.05）.There was a significant positive correlation between Caprini score and D-D and FIB levels in patients with DVT（P<0.05）.There was a positive correlation between Caprini score and level of D-D and FIB（r=0.748、r=0.662，P<0.05）.The sensitivity of Caprini score combined with D-D and FIB levels in the diagnosis of DVT in fracture patients was 97.83%，specificity was 92.00%，missed diagnosis rate was 2.17%，misdiagnosis rate was 8.00，and area under ROC curve was 0.947（P<0.05）.Conclusion Caprini score，D-D and FIB levels in patients with lower limb fracture have certain clinical value for the diagnosis of DVT.

Key words: Caprini score, D-two dimer, fibrinogen, fracture, deep vein thrombosis of lower extremity

徐亮, 刘凤英, 丁倩. Caprini评分、D-二聚体、纤维蛋白原水平在骨折后下肢深静脉血栓病人中的变化及其临床意义[J]. 临床外科杂志, 2019, 27(4): 328-330.

XU Liang, LIU Fengying, DING Qian.. The changes of Caprini score，D-D and FIB levels in post-fracture DVT patients and their diagnostic significance[J]. JOURNAL OF CLINICAL SURGERY, 2019, 27(4): 328-330.

参考文献

相关文章 15

[1]	陈森, 方洪松, 金志辉, 彭昊. 抗骨质疏松治疗在老年粗隆间骨折股骨近端防旋髓内钉术后病人中的应用[J]. 临床外科杂志, 2019, 27(5): 433-435.
[2]	吴磊, 朱琳蓉, 张广源, 牛兴邦. 关节镜下关节清理扩创微骨折术治疗膝骨关节炎的临床分析[J]. 临床外科杂志, 2019, 27(4): 313-315.
[3]	黄伟, 罗云蔓, 程中华. 经椎板间隙小开窗与经椎弓根椎体内植骨治疗胸腰椎爆裂性骨折的疗效比较[J]. 临床外科杂志, 2019, 27(4): 320-323.
[4]	郑辉, 陈新文, 王成伟, 罗斌, 梁玲玲. 不同手术方式对老年骨质疏松性股骨颈骨折病人骨密度及骨代谢的影响[J]. 临床外科杂志, 2019, 27(4): 335-337.
[5]	李维, 黄永超. 经皮微创内固定联合术后唑来膦酸治疗胸腰椎骨折的疗效及对T细胞亚群的影响[J]. 临床外科杂志, 2019, 27(4): 345-348.
[6]	余智, 韩森东. PVP充填自固化磷酸钙骨水泥对老年疼痛性骨质疏松性胸腰椎骨折疼痛及生活质量的影响[J]. 临床外科杂志, 2019, 27(3): 243-246.
[7]	郭乃铭, 罗筱玮, 彭俊, 徐海涛, 黄梦全, 李裕标. 分体式髌骨爪联合空心螺钉内固定治疗髌骨粉碎性骨折的疗效观察[J]. 临床外科杂志, 2019, 27(2): 158-159.
[8]	曾峥, 王冰, 刘洋. 双极人工股骨头治疗股骨颈骨折合并帕金森病的疗效[J]. 临床外科杂志, 2019, 27(2): 160-162.
[9]	邓乐章, 周益, 许勇. 髋关节置换术后股骨假体周围骨折危险因素分析[J]. 临床外科杂志, 2019, 27(2): 163-165.
[10]	任伟, 郑慧锋, 牛晶, 胡永成, Jike Lu. 加压空芯螺钉张力带治疗髌骨骨折的扩大手术适应证和手术技巧36例分析[J]. 临床外科杂志, 2019, 27(1): 76-78.
[11]	李峰庞争取范达文张修春. 伤椎后1/3切除重建治疗胸腰椎爆裂性骨折的疗效及对脊髓神经功能的影响[J]. 临床外科杂志, 2018, 26(9): 705-708.
[12]	王华, 张坤, 李飞 . 深筋膜下非接触锁定钢板治疗隐匿感染性股骨再骨折的效果观察[J]. 临床外科杂志, 2018, 26(12): 959-961.
[13]	赵灏, 陈世宏, 黄旭平. 股骨近端防旋髓内钉治疗不稳定性老年股骨粗隆间骨折的临床分析[J]. 临床外科杂志, 2018, 26(12): 962-964.
[14]	帕孜拉·艾拉, 艾克白尔·吐逊, 阿布都热衣木·艾尼. 经尺骨鹰嘴截骨与经肱三头肌舌形瓣入路治疗成人AOC型肱骨骨折的疗效比较[J]. 临床外科杂志, 2018, 26(12): 965-967.
[15]	林佩达黄家麒卢化祥黄晟刘光杨广林王福音何冰冰刘晓兵. 经皮机械性血栓清除术治疗创伤病人下肢深静脉血栓形成的安全性和早期疗效分析[J]. 临床外科杂志, 2018, 26(11): 810-813.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed