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[1]劉中懷,李嘉平,王偉,等.術(shù)前血清趨化因子配體3和P-選擇素水平預(yù)測骨盆骨折術(shù)后下肢深靜脈血栓形成的應(yīng)用價值[J].中醫(yī)正骨,2024,36(11):10-14.
　LIU Zhonghuai,LI Jiaping,WANG Wei,et al.The application value of presurgical serum chemokine(C-C motif)ligand 3 and P-selectin levels in predicting lower limb deep venous thrombosis following the pelvic fracture surgery[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(11):10-14.
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術(shù)前血清趨化因子配體3和P-選擇素水平預(yù)測骨盆骨折術(shù)后下肢深靜脈血栓形成的應(yīng)用價值()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年11期
頁碼:
10-14
欄目:
臨床研究
出版日期:
2024-11-20

文章信息/Info

Title:
The application value of presurgical serum chemokine(C-C motif)ligand 3 and P-selectin levels in predicting lower limb deep venous thrombosis following the pelvic fracture surgery
作者:
劉中懷; 李嘉平; 王偉; 李云偉; 李蕭; 姜磐
廊坊市第四人民醫(yī)院,河北 廊坊 065700
Author(s):
LIU Zhonghuai; LI Jiaping; WANG Wei; LI Yunwei; LI Xiao; JIANG Pan
The Fourth People's Hospital of Langfang,Langfang 065700,Hebei,China
關(guān)鍵詞:
骨盆;  骨折;  靜脈血栓形成;  趨化因子類;  配體;  P-選擇素;  危險因素;  Logistic模型;  ROC曲線
Keywords:
pelvis;  fractures; bone;  venous thrombosis;  chemotactic factors;  ligands;  P-selectin;  risk factors;  Logistic models;  ROC curve
摘要:
目的:探討術(shù)前血清趨化因子配體3和P-選擇素水平預(yù)測骨盆骨折術(shù)后下肢深靜脈血栓形成(deep venous thrombosis,DVT)的應(yīng)用價值。方法:納入擬采用手術(shù)治療的骨盆骨折患者,從病歷系統(tǒng)中提取年齡、性別、體質(zhì)量指數(shù)、是否合并高血壓、是否合并糖尿病等信息。于手術(shù)前1 d采集患者靜脈血,檢測血清總膽固醇、甘油三酯、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、C反應(yīng)蛋白、血紅蛋白、趨化因子配體3及P-選擇素水平,以及血漿纖維蛋白原水平、D-二聚體水平、活化部分凝血活酶時間、凝血酶原時間、凝血酶時間。于手術(shù)后1 d、7 d、14 d分別檢測患者下肢DVT的發(fā)生情況。根據(jù)患者術(shù)后是否發(fā)生下肢深靜脈血栓將納入的患者分為下肢DVT組和無下肢DVT組。先對2組患者的相關(guān)信息進(jìn)行單因素分析,然后對其中組間差異有統(tǒng)計學(xué)意義的因素進(jìn)行多因素Logistic回歸分析。采用受試者操作特征(receiver operating characteristic,ROC)曲線評價影響因素預(yù)測骨盆骨折術(shù)后下肢DVT的應(yīng)用價值。結(jié)果:共納入196例骨盆骨折患者,下肢DVT組38例,無下肢DVT組158例。單因素分析結(jié)果顯示,2組患者術(shù)前血清高密度脂蛋白膽固醇、C反應(yīng)蛋白、血紅蛋白、趨化因子配體3、P-選擇素水平,以及血漿纖維蛋白原、D-二聚體水平比較,組間差異均有統(tǒng)計學(xué)意義[(1.04±0.22)mmol·L-1,(1.21±0.35)mmol·L-1,t=2.858,P=0.005;(36.18±3.72)mg·L-1,(23.48±2.69)mg·L-1,t=24.116,P=0.000;(98.43±9.65)g·L-1,(91.28±9.21)g·L-1,t=4.257,P=0.000;(15.65±2.13)pg·mL-1,(12.57±1.76)pg·mL-1,t=9.283,P=0.000;(45.43±5.11)ng·mL-1,(38.57±4.06)ng·mL-1,t=8.871,P=0.000;(4.57±0.53)g·L-1,(3.72±0.41)g·L-1,t=10.804,P=0.000;(978.64±98.73)μg·L-1,(467.45±48.26)μg·L-1,t=46.239,P=0.000]。Logistic回歸分析結(jié)果顯示,術(shù)前血清趨化因子配體3和P-選擇素水平是術(shù)后下肢DVT的危險因素(β=0.921,P=0.008,OR=2.513; β=0.730,P=0.001,OR=2.076)。ROC曲線分析結(jié)果顯示,術(shù)前血清趨化因子配體3水平聯(lián)合血清P-選擇素水平預(yù)測骨盆骨折術(shù)后下肢DVT的ROC曲線下面積為0.935(P=0.000)。結(jié)論:術(shù)前血清趨化因子配體3和P-選擇素水平是骨盆骨折術(shù)后下肢DVT的危險因素,二者聯(lián)合預(yù)測骨盆骨折術(shù)后下肢DVT具有較高的應(yīng)用價值。
Abstract:
Objective:To explore the applied value of presurgical serum levels of chemokine(C-C motif)ligand 3(CCL3)and P-selectin in predicting lower limb deep venous thrombosis(LDVT)following the pelvic fracture surgery.Methods:The patients with pelvic fractures scheduled for being treated by surgery were selected and enrolled in the study,and the information including age,gender,body mass index,whether combined with hypertension,and whether combined with diabetes was extracted from the Electronic Medical Record System(EMRS).On presurgical day 1,the blood was drawn from the vein,and the serum levels of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),C-reactive protein(CRP),hemoglobin(Hb),CCL3 and P-selectin,the plasma levels of fibrinogen(FIB)and D-dimer,the activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)were detected.On postsurgical day 1,7 and 14,the incidence of LDVT was assessed,respectively.The patients were divided into LDVT group and non-LDVT group according to whether LDVT was found after the surgery.The single-factor analysis was conducted on the extracted information of patients in the 2 groups,followed by multi-factor logistic regression analysis on the factors with statistically significant differences between the 2 groups.Furthermore,the applied values of influencing factors in predicting LDVT following the pelvic fracture surgery were analyzed and evaluated by using receiver operating characteristic(ROC)curve.Results:One hundred and ninety-six patients with pelvic fracture were included in the final analysis,38 cases in LDVT group and 158 cases in non-LDVT group.The single-factor analysis showed that the differences were statistically significant between LDVT group and non-LDVT group in the serum levels of HDL-C,CRP,Hb,CCL3 and P-selectin,as well as the plasma levels of FIB and D-dimer(1.04±0.22 vs 1.21±0.35 mmol/L,t=2.858,P=0.005; 36.18±3.72 vs 23.48±2.69 mg/L,t=24.116,P=0.000; 98.43±9.65 vs 91.28±9.21 g/L,t=4.257,P=0.000; 15.65±2.13 vs 12.57±1.76 pg/mL,t=9.283,P=0.000; 45.43±5.11 vs 38.57±4.06 ng/mL,t=8.871,P=0.000; 4.57±0.53 vs 3.72±0.41 g/L,t=10.804,P=0.000; 978.64±98.73 vs 467.45±48.26 μg/L,t=46.239,P=0.000).The logistic regression analysis revealed that the presurgical serum levels of CCL3 and P-selectin were the risk factors for LDVT in patients with pelvic fracture after the surgery(β=0.921,P=0.008,OR=2.513; β=0.730,P=0.001,OR=2.076).The results of ROC curve analysis showed that the area under the ROC curve of presurgical serum levels of CCL3 and P-selectin in predicting LDVT after the pelvic fracture surgery was 0.935(P=0.000).Conclusion:The presurgical serum levels of CCL3 and P-selectin are the risk factors for LDVT in patients with pelvic fracture after the surgery,and their combination displays high application value in predicting LDVT after the pelvic fracture surgery.

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備注/Memo

備注/Memo:
基金項(xiàng)目:2023年廊坊市科學(xué)技術(shù)研究與發(fā)展計劃自籌經(jīng)費(fèi)項(xiàng)目(2023013007)
更新日期/Last Update: 1900-01-01