外周血t-PAIC、PIC结合超声弹性成像技术在下肢DVT评估中的应用价值

Application of peripheral blood t-PAIC and PIC combined with ultrasound elastography in evaluating DVT of lower limbs

目的:探讨外周血组织型纤溶酶原激活物/纤溶酶原激活物抑制剂-1复合物(t-PAIC)、纤溶酶-α_(2)纤溶酶抑制物复合物(PIC)结合超声弹性成像技术在下肢深静脉血栓(DVT)评估中的应用价值。方法:选取206名疑似下肢DVT患者为研究对象,将临床确诊为下肢DVT的患者纳入DVT组(n=41),非下肢DVT患者纳入非DVT组(n=165);DVT组患者再根据分期分为急性期组(n=14)、亚急性期组(n=16)和慢性期组(n=11)。比较DVT组和非DVT组、DVT组中不同分期患者外周血指标(t-PAIC及PIC水平)、超声弹性成像参数(超声弹性成像评分及应变值)、Caprini血栓风险评分水平差异;采用Pearson相关性分析其与下肢DVT分期的相关性;ROC曲线评估其对下肢DVT的诊断价值。结果:DVT组患者t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分均高于非DVT组(P<0.05)。DVT组中不同分期患者外周血t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分比较,差异均有统计学意义(P<0.05),且急性期<亚急性期<慢性期。相关性分析显示,t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分与下肢DVT分期均呈正相关关系(r=0.654、0.812、0.514、0.711、0.681,P<0.05)。ROC曲线分析显示,外周血t-PAIC及PIC水平、超声弹性成像评分及应变值、Caprini血栓风险评分及联合检测下肢DVT的曲线下面积(AUC)分别为0.754,0.765,0.759,0.730,0.752和0.894,联合检测诊断价值更高(P<0.05)。结论:外周血t-PAIC、PIC水平联合超声弹性成像技术对下肢DVT有较好的诊断价值,且有利于疾病分期。

Objective:To analyze the evaluation value of peripheral blood tissue plasmin activator/plasmin activator inhibitor-1 complex(t-PAIC)and plasmin-α_(2) plasmin inhibitor complex(PIC)combined with ultrasound elastography in deep vein thrombosis(DVT)of lower limbs.Methods:A total of 206 patients with suspected lower limb DVT were enrolled as the research objects.According to presence or absence of DVT by clinical diagnosis,patients were divided into DVT group(n=41)and non-DVT group(n=165).Patients in the DVT group were further divided into acute stage group(n=14),subacute stage group(n=16),and chronic stage group(n=11)based on stage.The levels of peripheral blood indicators(t-PAIC and PIC levels),ultrasound elastography parameters(elastography score and strain value),the risk of Caprini thrombosis were compared in DVT group,non DVT group,and DVT group patients at different stages.Pearson correlation analysis was used to determine its correlation with lower limb DVT staging,and their diagnostic value for lower limb DVT was evaluated by receiver operating characteristic(ROC)curves.Results:The levels of peripheral blood t-PAIC and PIC,elastography score,strain value and the risk of Caprini thrombosis in DVT group were higher than those in non-DVT group(P<0.05).The levels of peripheral blood t-PAIC and PIC,elastography parameters,strain value and the risk of Caprini thrombosis were increased successively in patients with lower limb DVT during acute stage,subacute stage and chronic stage(P<0.05).Correlation analysis showed that the peripheral blood t-PAIC,PIC,elastography score,strain value and the risk of Caprini thrombosis were positively correlated with disease staging(r=0.654,0.812,0.514,0.711,0.681,P<0.05).ROC curves analysis showed that AUC values of elastography score,strain value,peripheral blood t-PAIC,PIC,the risk of Caprini thrombosis and combined detection for evaluating lower limb DVT were 0.754,0.765,0.759,0.730,0.752 and 0.894,and combined detection had higher diagnostic value(P<0.05).Conclusion:Peripheral blood t-PAIC and PIC combined with ultrasound elastography have good diagnostic efficiency for lower limb DVT,which is conducive to the diagnosis of disease staging.