超声弹性成像参数联合D-二聚体诊断下肢深静脉血栓形成的临床研究

Clinical study of ultrasonic elastography parameters combined with D-dimer in the diagnosis of lower extremity deep venous thrombosis

目的:探讨超声弹性成像参数联合D-二聚体(D-D)在下肢深静脉血栓(DVT)中应用价值。方法:选取224例疑似DVT患者行超声弹性成像检查,并抽血测定血浆中D-D水平,将深静脉造影作为金标准,探讨超声弹性成像参数联合D-D在DVT中的诊断价值。结果:224例受试者中45例确诊为DVT,179例非DVT;DVT患者超声弹性成像评分、应变值高于非DVT者,D-D低于非DVT者(P<0.05),且超声弹性成像评分、应变值、D-D联合在DVT中诊断敏感度为94.33%,特异度为81.25%;不同分期患者超声弹性成像评分、应变值、D-D比较,差异有统计学意义(P<0.05);超声弹性成像评分、应变值与下肢DVT疾病分期呈正相关(P<0.05),D-D与下肢DVT疾病分期呈负相关(P<0.05);超声弹性成像参数联合血浆D-D对下肢DVT患者疗效预测敏感度为84.62%、特异度70.64%。结论:超声弹性成像参数联合血浆D-D在下肢DVT早期诊断中应用较佳,可为疾病分期诊断提供依据,二者联合应用在临床治疗中具有指导意义。

Objective:To investigate the clinical application value of ultrasonic elastography parameters combined with D-dimer(D-D)in the diagnosis of lower extremity deep venous thrombosis(DVT).Methods:A total of 224 patients suspected of DVT underwent ultrasonic elastography,and plasma D-D level was measured.Deep vein angiography was taken as the golden standard to discuss the diagnostic value of ultrasonic elastography parameters combined with D-D in DVT.Results:It was confirmed that among 224 subjects,45 were diagnosed as DVT and 179 were non DVT.The ultrasound elastography scores and strain values of DVT patients were higher than those of non DVT patients,and D-D was lower than that of non DVT patients(P<0.05),the diagnostic sensitivity and specificity of ultrasound elastography score,strain value and D-D combination in DVT were 94.33%and 81.25%.There were significant differences in ultrasonic elastography score,strain value and D-D in patients with different stages(P<0.05).Ultrasound elastography score and strain value were positively correlated with lower extremity DVT disease stage(P<0.05),and D-D was negatively correlated with lower extremity DVT disease stage(P<0.05).The sensitivity and specificity of ultrasound elastography parameters combined with plasma D-D in predicting the efficacy of patients with lower extremity DVT were 84.62%and 70.64%.Conclusion:Ultrasonic elastography parameters combined with plasma D-D can assist in the early diagnosis of lower extremity DVT,and provide a basis for staging diagnosis of the disease.The combination of the two is of guiding significance in clinical treatment.