纤维蛋白原/白蛋白比值、Caprini评分、D-二聚体对急性脑梗死后下肢深静脉血栓形成的预测价值

Predictive value of fibrinogen/albumin ratio,Caprini score,and D-dimer for lower extremity deep venous thrombosis after acute cerebral infarction

目的 探讨纤维蛋白原/白蛋白比值(FAR)、Caprini评分、D-二聚体(D-D)对急性脑梗死后下肢深静脉血栓(LDVT)形成的预测价值。方法 选取2019年7月至2023年3月在安徽省芜湖市中医医院神经内科住院的急性脑梗死患者122例,根据住院期间双下肢静脉彩超结果将其分为血栓组(42例)和无血栓组(80例),收集两组的基本资料,比较两组FAR、Caprini评分、D-D等指标的差异。建立logistic回归模型分析急性脑梗死后LDVT形成的影响因素,绘制受试者操作曲线比较FAR、Caprini评分、D-D单独及联合对急性脑梗死后LDVT形成的预测价值。结果 血栓组糖尿病患者占比、美国国立卫生研究院卒中量表评分>14分患者占比、格拉斯哥昏迷量表评分>8分患者占比、使用脱水药物>5 d患者占比、Caprini评分及D-D、FAR水平均高于无血栓组,差异有统计学意义(P<0.05)。多因素分析结果显示,Caprini评分(OR=1.803,95%CI:1.173~2.769)、D-D(OR=1.589,95%CI:1.235~2.043)、FAR(OR=1.609,95%CI:1.075~2.408)为急性脑梗死后LDVT形成的独立影响因素(P<0.05)。Caprini评分、FAR、D-D三者联合预测急性脑梗死后LDVT形成的受试者操作曲线下面积高于三者单独预测(P<0.05)。结论 FAR、Caprini评分、D-D与急性脑梗死后LDVT形成有关,可作为LDVT的预测指标,三者联合检测能提高预测效能。

Objective To investigate the predictive value of fibrinogen/albumin ratio(FAR),Caprini score,and D-dimer(D-D) for lower extremity deep vein thrombosis(LDVT) after acute cerebral infarction.Methods A total of 122 patients with acute cerebral infarction hospitalized in the Department of Neurology,Wuhu Traditional Chinese Medicine Hospital in Anhui Province from July 2019 to March 2023 were selected.According to the results of color Doppler ultrasound of both lower limbs during hospitalization,they were divided into thrombosis group(42 cases) and non-thrombosis group(80 cases).Basic data of the two groups were collected,the differences of FAR,Caprini score,D-D,and other indicators between the two groups were compared.The logistic regression model was established to analyze the influencing factors of LDVT formation after acute cerebral infarction,and the receiver operating curve was drawn to compare the predictive value of FAR,Caprini score,D-D alone and in combination for LDVT formation after acute cerebral infarction.Results The proportion of patients with diabetes mellitus,the proportion of patients with National Institutes of Health stroke scale score > 14 points,proportion of patients with Glasgow coma scale score > 8 points,the proportion of patients using dehydration drugs > five days,Caprini score,D-D,and FAR levels in the thrombosis group were higher than those in the non-thrombosis group,and the differences were statistically significant(P<0.05).Multivariate analysis showed that Caprini score(OR=1.803,95%CI:1.173-2.769),D-D(OR=1.589,95%CI:1.235-2.043),FAR(OR= 1.609,95%CI:1.075-2.408) were the independent influencing factors of LDVT after acute cerebral infarction(P <0.05).The area under the receiver operating curve of combined prediction of Caprini score,FAR,and D-D in predicting LDVT formation after acute cerebral infarction was higher than that of the three alone(P<0.05).Conclusion FAR,Caprini score,and D-D are related to the formation of LDVT after acute cerebral infarction,and can be used as predictors of LDVT.Their combined detection can improve the predictive efficiency.