D二聚体、FDP、炎性因子联合检测在预测髋关节置换术后LDVT的作用

Value of combined detection of D-D,FDP and inflammatory factors in predicting LDVT after hip arthroplasty

目的探讨D二聚体、FDP、炎性因子联合检测在预测髋关节置换术后LDVT的价值。方法将内蒙古医科大学附属医院90例股骨颈骨折并接受人工髋关节置换术的患者纳入研究,根据术后7d有无血栓生成血栓组(25例)及无血栓组(65例),并将同期30例健康体检人员设置为健康对照组,比较各组双下肢周径差、外周血D二聚体、FDP、CRP、IL-6、IL-8水平变化,并利用Spearman秩相关分析各指标与大小腿围的相关性。结果(1)术前三组患者双下肢周径差无统计学差异(P>0.05),术后7d,血栓组患者患肢与健侧周径差较正常对照组及无血栓组明显增加,差异有统计学意义(P<0.05);(2)术前三组患者D二聚体、FDP、CRP、IL-6、IL-8水平差异无统计学意义(P>0.05),术后7d,血栓组患者D二聚体、FDP、CRP、IL-6、IL-8水平较正常对照组及无血栓组明显增加,差异有统计学意义(P<0.05);(3)线性相关显示,D二聚体、FDP、CRP、IL-6、IL-8与小腿围及大腿围均具有相关性(P<0.05),D二聚体、FDP与CRP、IL-6、IL-8均具有相关性(P<0.05)。结论D二聚体、FDP、IL-6、IL-8与LDVT发生密切相关,可作为LDVT监测指标。

Objective To explore the value of combined detection of D-D,FDP and inflammatory factors in predicting LDVT after hip arthroplasty.Methods 90 patients with femoral neck fracture who underwent total hip arthroplasty were included in the study.According to the thrombosis group(25 cases)and non thrombosis group(65 cases)three days after operation,30 healthy physical examination personnel in the same period were set as the healthy control group.The changes of peripheral diameter difference of both lower limbs,peripheral blood D-D,FDP,CRP,IL-6 and IL-8 in each group were compared,Spearman rank correlation was used to analyze the correlation between each index and leg circumference.Results(1)There was no significant difference in the peripheral diameter difference of both lower limbs among the three groups before operation(P>0.05).7 days after operation,the peripheral diameter difference between the affected limb and the healthy side in the thrombosis group was significantly higher than that in the normal control group and the non thrombosis group(P<0.05);(2)There was no significant difference in the levels of D-D,FDP,CRP,IL-6 and IL-8 among the three groups before operation(P>0.05).Three days after operation,the levels of D-D,FDP,CRP,IL-6 and IL-8 in the thrombosis group were significantly higher than those in the normal control group and the non thrombosis group(P<0.05);(3)Linear correlation showed that D-D polymer,FDP,CRP,IL-6 and IL-8 were correlated with calf circumference and thigh circumference(P<0.05),and D-D polymer and FDP were correlated with CRP,IL-6 and IL-8(P<0.05).Conclusion D-D,FDP,IL-6 and IL-8 are closely related to the occurrence of LDVT and can be used as the monitoring index of LDVT.