高频超声联合D-二聚体、纤维蛋白原对小腿肌间静脉丛血栓形成的诊断价值

Diagnostic value of high-frequency ultrasound combined with D-dimer and fibrinogen for the thrombosis of muscular calf vein thrombosis

目的 探讨高频超声结合D-二聚体(D-D)、纤维蛋白原(FIB)对小腿肌间静脉丛血栓形成(MCVT)的诊断价值。方法 收集2021年12月至2022年5月安徽中医药大学第二附属医院住院期间80例疑似MCVT患者的临床资料,依据是否发生血栓分为血栓组和非血栓组,各40例。比较两组患者的血清D-D、FIB水平,并分析MCVT患者血清D-D水平与FIB水平的相关性。以实验室检测结果为金标准,评估D-D、FIB、高频超声单独及联合对MCVT的诊断价值。结果 血栓组患者的血清D-D、FIB水平均明显高于非血栓组患者,差异均有统计学意义(P<0.01)。相关性分析结果显示,血栓组患者的血清FIB水平与D-D水平呈正相关(r=0.362,P<0.05)。高频超声联合D-D、FIB诊断MCVT的灵敏度为80.00%,特异度为90.00%,准确度为85.00%,高于单项指标的诊断结果。结论 高频超声可显示下肢肌间静脉管腔中的异常回声,判断MCVT的部位,其结合D-D、FIB检测对MCVT的诊断价值较高,具有较高的临床应用价值。

Objective To investigate the diagnostic value of high-frequency ultrasound combined with D-dimer(D-D) and fibrinogen(FIB) for muscular calf vein thrombosis(MCVT). Method The clinical data of 80 patients who were suspected of MCVT during hospitalization in the Second Affiliated Hospital of Anhui University of Chinese Medicine from December 2021 to May 2022 were collected. According to the presence or absence of thrombosis, the patients were divided into thrombosis group and non-thrombosis group, with 40 cases in each group. Serum D-D and FIB levels in the two groups were comparatively analyzed, the correlation between serum D-D and FIB levels in patients with MCVT was analyzed. The laboratory test results were taken as the golden standard to evaluate the diagnostic value of D-D, FIB alone and combined with high-frequency ultrasound for MCVT. Result Serum D-D and FIB levels in the thrombosis group were significantly higher than those in the non-thrombosis group(P<0.01). Correlation analysis showed that serum FIB level was positively correlated with serum D-D level in the thrombosis group(r=0.362, P<0.05). The sensitivity,specificity and accuracy of high-frequency ultrasound combined with D-D and FIB for diagnosing MCVT were 80.00%,90.00% and 85.00%, higher than those of single diagnosis. Conclusion High-frequency ultrasound can show abnormal echoes in intermuscular lumen of lower limb, thereby helping determine the location of MCVT. Its combination with D-D and FIB detection is of high diagnostic value in the diagnosis of MCVT and has high clinical application value.