闭合性骨折后下肢DVT患者D-二聚体、纤维蛋白原与Caprini评分的相关性分析

Correlation Analysis of D-Dimer,Fibrinogen and Caprini Score in Patients with Lower Extremity DVT After Closed Fracture

目的分析闭合性骨折后下肢深静脉血栓(DVT)患者D-二聚体、纤维蛋白原与Caprini评分的相关性。方法选择2017年1月~2019年10月我院收治的136例闭合性骨折患者作为研究对象,根据是否并发下肢DVT进行分组,其中42例闭合性骨折后发生下肢DVT患者作为观察组,94例骨折后未发生下肢DVT患者作为对照组,比较两组血浆D-二聚体、纤维蛋白原水平及Caprini评分,采用多因素Logistic回归分析及Pearson相关性分析D-二聚体、纤维蛋白原与Caprini评分的相关性,采用受试者工作特征(ROC)曲线评价D-二聚体、纤维蛋白原联合Caprini评分对闭合性骨折后下肢DVT的预测效能。结果观察组血浆D-二聚体、纤维蛋白原水平及Caprini评分均高于对照组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,D-二聚体、纤维蛋白原水平及Caprini评分均是闭合性骨折后下肢DVT的独立影响因素(P<0.05);Pearson相关性分析显示,闭合性骨折后下肢DVT患者血浆D-二聚体、纤维蛋白原水平均与Caprini评分呈正相关(r=0.542、0.631,P<0.05);ROC曲线分析显示,D-二聚体、纤维蛋白原联合Caprini评分预测闭合性骨折后下肢DVT的ROC曲线下面积(AUC)为0.915,高于D-二聚体的0.710、纤维蛋白原的0.640和Caprini评分的0.680,差异有统计学意义(Z=4.812、5.621、6.127,P<0.05)。结论闭合性骨折后下肢DVT患者D-二聚体、纤维蛋白原与Caprini评分的关系密切,三者联合预测下肢DVT的效能较好。

Objective To analyze the correlation between D-dimer,fibrinogen and Caprini score in patients with lower extremity deep vein thrombosis(DVT)after closed fracture.Methods A total of 136 patients with closed fractures admitted to our hospital from January 2017 to October 2019 were selected as the research subjects.They were grouped according to whether they had concurrent lower limb DVT.Among them,42 patients with lower limb DVT after closed fracture were used as the observation group and 94 fractures were observed.Patients who did not develop lower extremity DVT were used as a control group.Plasma D-dimer,fibrinogen levels and Caprini scores were compared between the two groups.Multivariate Logistic regression analysis and Pearson correlation analysis were used to analyze D-dimer,fibrinogen and Caprini correlation of the scores,using the receiver operating characteristic(ROC)curve to evaluate the predictive power of D-dimer,fibrinogen,and Caprini scores for lower limb DVT after closed fractures.Results The levels of D-dimer,fibrinogen and Caprini scores in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that D-dimer,fibrinogen level,and Caprini score were independent factors affecting lower limb DVT after closed fracture(P<0.05);Pearson correlation analysis showed that lower limb DVT after closed fracture Patients'plasma D-dimer and fibrinogen levels were positively correlated with Caprini scores(r=0.542,0.631,P<0.05);ROC curve analysis showed that D-dimer and fibrinogen combined with Caprini scores predict closed fractures The area under the ROC curve(AUC)of hindlimb DVT was 0.915,which was higher than 0.710 for D-dimer,0.640 for fibrinogen,and 0.680 for Caprini score,the differences were statistically significant(Z=4.812,5.621,6.127,P<0.05).Conclusion D-dimer,fibrinogen,and Caprini score are closely related in patients with DVT of lower extremity after closed fracture.The combination of the three predicts the effectiveness of DVT in lower extremity.