凝血指标和D-二聚体及FDP水平检测对骨折病人的临床意义

Clinical significance of the detection of coagulation index,D-dimer and FDP level in patients with fracture

目的:探讨凝血指标和D-二聚体(DD)及血浆纤维蛋白原降解产物(FDP)水平检测对骨折病人的临床意义。方法:选取骨折病人57例作为观察组,同期健康体检者68名作为对照组,比较2组凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)和DD、FDP水平,并比较观察组不同类型骨折病人Fg、DD、FDP阳性率,以及发生深静脉血栓(DVT)与未发生DVT病人的Fg、DD、FDP水平。结果:观察组Fg、DD、FDP水平均明显高于对照组(P<0.01),TT低于对照组(P<0.05),2组PT和APTT差异均无统计学意义(P>0.05)。观察组中不同类型骨折病人Fg、DD阳性率差异均无统计学意义(P>0.05),FDP阳性率差异有统计学意义(P<0.05)。术前1 d,观察组中发生DVT与未发生DVT病人的Fg、DD、FDP水平差异无统计学意义(P>0.05);术后7 d,发生DVT病人Fg、DD和FDP水平均明显高于未发生DVT病人(P<0.01),且发生DVT病人Fg、DD、FDP水平均较术前1 d明显升高(P<0.01)。结论:凝血指标和DD、FDP水平可有效反映骨折病人凝血功能,灵敏度较高,对预防病人DVT形成具有一定的指导价值。

Objective:To explore the clinical significance of the coagulation parameters,D-dimer(DD)and plasma fibrinogen degradation product(FDP)levels in patients with fractures.Methods:A total of 57 fracture patients and 68 healthy people were divided into the observation group and control group,respectively.The prothrombin time(PT),activated partial prothrombin time(APTT)and thrombin time(TT),and levels of fibrinogen(Fg),DD and FDP were compared between two groups.Among the patients in observation group with different types of fractures,the positive rates of Fg,DD and FDP,levels of Fg,DD and FDP in patients with and without deep vein thrombosis(DVT)were compared.Results:The levels of Fg,DD and FDP in observation group were significantly higher than those in control group(P<0.01),the level of TT in observation group was lower than that in control group(P<0.05),and the differences of the level of PT and APTT between two groups were not statistically significant(P>0.05).The differences of the positive rates of Fg and DD in observation group with different types fracture were not statistically significant(P>0.05),and the difference of the positive rate of FDP in observation group with different types fracture was statistically significant(P<0.05).Before 1 day of operation,the differences of the levels of Fg,DD and FDP in observation group between patients with and without DVT were not statistically significant(P>0.05).After 7 days of operation,the levels of Fg,DD and FDP in patients with DVT were significantly higher than those in patients without DVT(P<0.01),and the levels of Fg,DD and FDP in patients with DVT significantly increased compared with before 1 day of operation(P<0.01).Conclusions:Coagulation index,DD,FDP can effectively reflect the coagulation function of fracture patients,its sensitivity is high,and it has certain guiding value to prevent the DVT formation in patients.