血浆D-二聚体在预测扭转睾丸存活力中的价值

Clinical value of serum D-dimer level in prediction of postoperative vitality of testicular torsion

目的:探讨睾丸扭转后患者血浆D-二聚体(D-dimer)对扭转睾丸存活力的预测价值。方法:选取2014年1月—2020年2月我院收治的51例睾丸扭转患者为研究对象。根据治疗结果分为睾丸坏死组(29例)和睾丸存活组(22例),另随机选取本院同年龄段正常体检者20例为对照组。记录患者的睾丸扭转时间以及睾丸的扭转程度。收集并分析患者术前(正常体检者体检当日)的血白细胞计数(WBC)、血浆D-二聚体(D-dimer)、血小板计数(PLT)、血小板平均体积(MPV)。采用Logistic回归分析检验指标、扭转时间、扭转程度等对扭转睾丸存活力的预测价值,并进一步采用ROC曲线分析其预测睾丸存活力的准确度。结果:睾丸坏死组患者的D-dimer水平显著高于睾丸存活组和对照组(P<0.05)。睾丸存活组患者的D-dimer水平显著高于对照组(P<0.05)。睾丸坏死组和睾丸存活组WBC水平比较差异无统计学意义(P>0.05),但均显著高于对照组(P<0.05)。D-dimer水平是预测睾丸坏死的独立危险因素(P<0.05)。D-dimer预测睾丸坏死的AUC为0.877(P<0.05),最佳节点为145.5 ng/mL,灵敏度为89.7%,特异度为85.7%。结论:睾丸扭转患者术前血浆D-dimer水平对术前预测扭转睾丸存活力具有重要价值。

Objective: To study the clinical value of serum D-dimer level in prediction of postoperative vitality of testicular torsion. Methods: The clinical data in the 51 patients admitted to our hospital with testicular torsion from January 2014 to February 2020 were reviewed. According to the pathology results, they were divided into 29 cases in necrosis group and 22 cases in survival group. Other 20 normal patients were included in the control group. The onset time, degree of testicular torsion, and the preoperative WBC, D-dimer, PLT, MPV levels of patients were measured. The logistic regression was used to analyze the predictive value for vitality of twisted testicles. The ROC curve was used to analyze the accuracy of analytical results. Results: The level of D-dimer in necrosis group was significantly higher than that in others(P<0.05), and the survival group were significantly higher than control group(P<0.05). The level of WBC in necrosis group and survival group were significantly higher than that in control group(P<0.05). The level of D-dimer was a risk factor for predicting testicular necrosis. The AUC of D-dimer for predicting testicular necrosis was 0.877(P<0.05), and the best cut-off point was 145.5 ng/mL. The sensitivity was 89.7%, and the specificity was 85.7%. Conclusion: Level of serum D-dimer has important clinical value in predicting the postoperative vitality of testicular torsion.