PLR和DFR结合WELLS评分对青年脑出血患者下肢深静脉血栓的预测价值

PLR and DFR combined with WELLS score on lower extremity deep vein thrombosis in young patients with cerebral hemorrhage

目的研究血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)和D-二聚体与纤维蛋白原比值(D-dimer to fibrinogen ratio,DFR)结合WELLS评分对预测青年脑出血(young cerebral hemorrhage,YCH)患者并发下肢深静脉血栓(lower deep vein thromboembolism,LDVTE)的效果,实现早期诊断和预防治疗。方法选择本院收治的109例YCH患者为研究对象,分为血栓组(33例)和非血栓组(76例),通过受试者工作特征曲线(receiver operating characteristic curve,ROC)中的曲线下面积(areas under the curve,AUC)、灵敏度、特异度等指标评价PLR及DFR结合WELLS评分的诊断价值。结果血栓组的PLR数值、DFR数值及WELLS评分为(149.20±52.17)、(118.46±8.37)及(2.67±0.48);非血栓组分别为(95.27±29.48)、(75.28±10.16)及(0.72±0.34),差异均有统计学意义(P<0.05)。三者联合应用对YCH患者发生LEDVT的灵敏度为97.65%、特异度为92.43%、漏诊率为2.35%、误诊率为7.57%,ROC曲线下面积AUC值为0.951(P<0.05)。结论PLR、DFR结合WELLS评分对预测YCH患者发生LDVTE特异性高,漏诊率及误诊率低,有很好的临床实用价值,值得推广应用。

Objective To study the effects of platelet to lymphocyte ratio and D-dimer to fibrinogen ratio combined with WELLS score on the prediction of lower extremity deep vein thrombosis in young cerebral hemorrhage(YCH)patients.Methods One hundred and nine YCH patients in our hospital were divided into thrombus group(33 cases)and non-thrombus group(76 cases).The diagnostic value of PLR and DFR combined with WELLS score was evaluated by areas under the curve(AUC),sensitivity and specificity of receiver operating characteristic curve(ROC).Results PLR,DFR and WELLS score of thrombus group were(149.20±52.17),(118.46±8.37)and(2.67±0.48)respectively,and those of non-thrombus group were(95.27±29.48),(75.28±10.16)and(0.72±0.34)respectively,the differences were statistically significant(P<0.05).The sensitivity,specificity,missed diagnosis rate and misdiagnosis rate were 97.65%,92.43%,2.35%and 7.57%,respectively.AUC value of area under ROC curve was 0.951(P<0.05).Conclusion PLR,DFR combined with WELLS score has high specificity in predicting LDVTE in YCH patients,and the missed diagnosis rate and misdiagnosis rate are low.It has good clinical practical value and is worthy of popularization and application.