摘要
目的探讨血清可溶性CD40配体(SCD40L)、趋化因子配体3(CCL3)水平联合间接下肢CT静脉成像对髋部骨折患者术后下肢深静脉血栓(DVT)的诊断价值。方法选取2019年6月至2022年6月在湖州市第一人民医院行手术治疗的髋部骨折患者78例为研究对象,根据下肢静脉造影结果分为DVT组59例和无DVT组19例。于术前、术后24 h内分别取晨起空腹静脉血,采用ELISA法检测血清SCD40L、CCL3水平。以下肢静脉造影作为“金标准”,采用ROC曲线评估血清SCD40L、CCL3水平、间接下肢CT静脉成像及3者联合检测诊断术后DVT的效能。结果DVT组患者术后24 h血清SCD40L、CCL3水平均高于无DVT组(均P<0.05)。血清SCD40L、CCL3诊断髋部骨折患者术后DVT的AUC分别为0.799、0.852,灵敏度分别为0.864、0.712,特异度分别为0.790、0.895,两者联合诊断髋部骨折患者术后发生DVT的AUC为0.896,灵敏度为0.763,特异度为0.895。间接下肢CT静脉成像联合SCD40L、CCL3检测诊断术后DVT的AUC为0.985,灵敏度为0.966、特异度为0.947,准确率为96.15%,AUC、灵敏度、特异度和准确率均高于单一诊断方法(均P<0.05)。结论血清SCD40L、CCL3水平联合间接下肢CT静脉成像有助于提高髋部骨折患者术后DVT的诊断效能。
Objective To investigate the diagnostic value of serum soluble CD40 ligand(SCD40L)and chemokine ligand 3(CCL3)levels combined with indirect lower extremity CT venography for postoperative lower extremity deep venous thrombosis(DVT)in patients with hip fracture.Methods A total of 78 patients with hip fracture who underwent surgery in Huzhou First People's Hospital from June 2019 to June 2022 were enrolled.According to the results of lower extremity venography,there were 59 patients with DVT(DVT group)and 19 patients without DVT(non-DVT group).Fasting venous blood was collected before surgery and within 24 h after surgery to detect serum SCD40L and CCL3 levels.Using lower extremity venography as the"gold standard",the diagnostic efficacy of SCD40L,CCL3,indirect lower extremity CT venography and the combination of the three for postoperative DVT was analyzed.Results Serum SCD40L and CCL3 levels were higher in DVT group than those in the non-DVT group(both P<0.05).The area under the curve(AUC)of serum SCD40L and CCL3 for diagnosing postoperative DVT in patients with hip fracture was 0.799 and 0.852,the sensitivity was 0.864 and 0.712,and the specificity was 0.790 and 0.895.The AUC of the combination of SCD40L and CCL3 for diagnosing postoperative DVT was 0.896,with a sensitivity of 0.763 and specificity of 0.895.The AUC of the combination of three indicators for the diagnosis of postoperative DVT was 0.985,with a sensitivity of 0.966,specificity of 0.947 and accuracy of 96.15%,all of which were higher than those of three single indicators alone(all P<0.05).Conclusion Serum SCD40L and CCL3 levels combined with indirect lower extremity CT venography can improve the diagnostic efficacy of postoperative DVT in patients with hip fracture.
作者
郭攀
GUO Pan(Department of Orthopaedic Surgery,Huzhou First People's Hospital,Huzhou 313000,China)
出处
《浙江医学》
CAS
2023年第17期1847-1850,1861,共5页
Zhejiang Medical Journal
基金
湖州市公益性应用研究项目(2020GYB17)。
