摘要
目的分析骨折病人血浆中D-二聚体(D-D)和纤维蛋白原降解产物(FDP)水平变化,了解其二者联合检测在骨折诊断下肢深静脉血栓(DVT)方面的价值。方法回顾性分析了128例骨折病人血浆中D-D和FDP水平变化,其中骨折合并DVT组75例,骨折未合并DVT组53例。分别对两组患者开展下肢静脉超声检查、FDP与D-D检测,评估其临床诊断价值。对两组患者术后1 d、7 d、14 d、21 d的D-D和FDP的水平进行动态监测,以观察二者对骨折预后的影响。结果两组患者的D-D、FDP水平均有统计学差异(t=8.54,P=0.004;t=5.69,P=0.024)。骨折并DVT组患者D-D和FDP于骨折术后1 d内急剧升高,与骨折无DVT组比较均有显著性差异(t=6.89,P=0.000;t=5.19,P=0.000),骨折并DVT组患者D-D和FDP于术后21 d和14 d降至正常水平。D-D和FDP联合检测对骨折DVT患者的敏感性、特异性均高于二者单独检测。结论D-D和FDP联合检测可以提高二者单独检测对诊断DVT的敏感度和特异性,具有较高的诊断价值,二者动态监测还可作为骨折治疗及预后的监测指标。
Objective To analyze the changes of plasma D-Dimer(D-D)and fibrinogen degradation product(FDP)levels in fracture patients,and to understand the value of combined detection of D-D and FDP in the diagnosis of lower extremity deep venous thrombosis(DVT).Methods The changes of plasma D-D and FDP levels in 128 patients with fracture were retrospectively analyzed,including 75 fracture patients combined with DVT group and 53 fracture patients without DVT group.The lower extremity venous ultrasound,FDP and D-D detection were carried out in the two groups respectively to evaluate the clinical diagnostic value.The levels of D-D and FDP on 1 d,7 d,14 d and 21 d after operation in both groups were dynamically monitored to observe the effects on fracture prognosis.Results There were statistically significant differences in D-D and FDP between the two groups(t=8.54,P=0.004;t=5.69,P=0.024).The levels of D-D and FDP increased sharply within 1 d after operation in fracture patients with complicated with DVT,which was significantly different from that of patients without DVT(t=6.89,P=0.000;t=5.19,P=0.000).The levels of D-D and FDP decreased to normal level at 21 d and 14 d in DVT group.The sensitivity and specificity of combined detection of D-D and FDP were higher than those of single detection.Conclusion Combined detection of D-D and FDP can improve the sensitivity and specificity in the diagnosis of DVT and have high diagnostic value.The dynamic monitoring of D-D and FDP can also be used as the monitoring index of fracture treatment and prognosis.
作者
朱名超
朱娅
Zhu Mingchao;Zhu Ya(Department of Clinical Laboratory,The First People's Hospital of Tianmen City,Tianmen Hubei 431700,China;Department of Neurology,The First People's Hospital of Tianmen City,Tianmen Hubei 431700,China)
出处
《中华临床实验室管理电子杂志》
2020年第4期241-245,共5页
Chinese Journal of Clinical Laboratory Management(Electronic Edition）
基金
四川省医学科研青年创新课题(Q18025)。
关键词
D-D
FDP
动态监测
DVT
骨折术后
D-dimer
Fibrinogen degradation product
The dynamic monitoring
Deep vein thrombosis
Fracture surgery
