血清血小板活化因子、脂蛋白(a)、纤维蛋白单体对骨折患者发生近端深静脉血栓评估价值

Evaluation value of serum platelet activating factor,lipoprotein(a)and fibrin monomer on proximal deep vein thrombosis in fracture patients

目的探讨血清血小板活化因子、脂蛋白(a)、纤维蛋白单体对骨折患者发生近端深静脉血栓评估价值。方法选取自2018年1月至2020年1月收治的97例骨折患者为研究对象。将发生近端深静脉血栓患者纳入血栓组(n=34),未发生近端深静脉血栓患者纳入非血栓组(n=63),分析骨折患者发生近端深静脉血栓的危险因素。采用受试者工作特征(ROC)曲线分析血清血小板活化因子、脂蛋白(a)、纤维蛋白单体对骨折患者发生近端深静脉血栓的评估价值。结果多因素Logistic回归分析结果显示,受伤至入院时间、美国麻醉医师协会(ASA)分级、心血管系统疾病、并发症数量、血小板活化因子、脂蛋白(a)及纤维蛋白单体均是骨折患者发生近端深静脉血栓的独立危险因素(P<0.05)。ROC曲线结果显示,血清血小板活化因子预测骨折患者发生近端深静脉血栓的曲线下面积(AUC)为0.838(95%可信区间0.752~0.924,P=0),敏感度和特异度分别为0.831和0.845;脂蛋白(a)预测骨折患者发生近端深静脉血栓的AUC为0.752(95%可信区间0.636~0.868,P=0),敏感度和特异度分别为0.836和0.843;纤维蛋白单体预测骨折患者发生近端深静脉血栓的AUC为0.959(95%可信区间0.926~0.993,P=0),敏感度和特异度分别为0.843和0.854;联合检测时AUC为0.989(95%可信区间0.974~1.000,P=0),敏感度和特异度分别为0.886和0.932。结论受伤至入院时间、ASA分级、心血管系统疾病、并发症数量、血小板活化因子、脂蛋白(a)、纤维蛋白单体是骨折患者发生近端深静脉血栓的独立危险因素,患者入院后连续监测血小板活化因子、脂蛋白(a)、纤维蛋白单体对近端深静脉血栓有一定的预测价值。

Objective To investigate the evaluation value of serum platelet activating factor,lipoprotein(a)and fibrin monomer on proximal deep vein thrombosis in fracture patients.Methods A retrospective study was performed on 97 cases of patients with fracture who were admitted from January 2018 to January 2020.Patients with proximal deep vein thrombosis were included in the thrombosis group(n=34),and patients without proximal deep vein thrombosis were included in the non-thrombosis group(n=63).Risk factors for proximal deep vein thrombosis in fracture patients were analyzed.Receiver operating characteristic(ROC)curve was used to analyze the value of serum platelet activating factor,lipoprotein(a)and fibrin monomer in the evaluation of proximal deep vein thrombosis in fracture patients.Results Multivariate Logistic regression analysis showed that the time from injury to admission,American Society of Anesthesiologists(ASA)grading,cardiovascular diseases,the number of complications,platelet activating factor,lipoprotein(a)and fibrin monomer were independent risk factors for proximal deep vein thrombosis in fracture patients(P<0.05).The ROC curve results showed that the area under the curve(AUC)of serum platelet activation factor for predicting proximal deep vein thrombosis in fracture patients was 0.838(95%CI:0.752-0.924,P=0),and the sensitivity and specificity were 0.831 and 0.845,respectively.The AUC of lipoprotein(a)for predicting proximal deep vein thrombosis in fracture patients was 0.752(95%CI:0.636-0.868,P=0),and the sensitivity and specificity were 0.836 and 0.843,respectively.The AUC for predicting proximal deep vein thrombosis in fracture patients was 0.959(95%CI:0.926-0.993,P=0),and the sensitivity and specificity were 0.843 and 0.854,respectively.AUC was 0.989(95%CI:0.974-1.000,P=0),sensitivity and specificity were 0.886 and 0.932,respectively.Conclusion The time from injury to admission,ASA grading,cardiovascular system diseases,number of complications,platelet activating factor,lipoprotein(a)and fibrin monomer are independent risk factors for proximal deep vein thrombosis in fracture patients.Continuous monitoring of platelet activation factor,lipoprotein(a)and fibrin monomer after admission has certain predictive value for proximal deep vein thrombosis.