| 摘要: |
| 目的:探讨血清D-二聚体(D-D)、血栓素B2(TXB2)联合6-酮-前列腺素F1a(6-K-PGF1a)对人工全膝关节置换术(TKA)后并发下肢深静脉血栓(DVT)的预测价值。方法:选取拟行TKA 的156 例患者，根据术后是否并发下肢DVT 将其分为并发组(n=52)和非并发组(n=104)。检测并比较两组术前和术后24 h 血清D-D、TXB2、6-K-PGF1a水平，采用Logistic 回归分析TKA 后并发下肢DVT 的影响因素，绘制受试者工作特征(ROC)曲线，分析术后24 h 血清D-D、TXB2 联合6-K-PGF1a对TKA 后并发下肢DVT 的预测价值。结果:并发组术后24 h 血清D-D、TXB2 水平均高于非并发组(P＜0.05)，术后24 h 血清6-K-PGF1a水平低于非并发组(P＜0.05)；Logistic 回归分析显示，术后24 h 血清D-D、TXB2、6-K-PGF1a水平均是TKA 后并发下肢DVT 的影响因素(P＜0.05)；ROC 曲线分析显示，血清D-D、TXB2 联合6-K-PGF1a预测TKA 后并发下肢DVT 的灵敏度为94.23%，曲线下面积为0.925，均高于各指标单独预测(P＜0.05)，特异度与各指标单独预测基本一致。结论:术后24 h 血清D-D、TXB2、6-K-PGF1a水平均对TKA 后并发下肢DVT 具有一定的预测价值，但三者联合的预测价值更高。 |
| 关键词: D-二聚体 血栓素B2 6-酮-前列腺素F1a 人工膝关节置换术 下肢深静脉血栓 |
| DOI：10.3969/j.issn.1007-6948.2024.05.018 |
| 投稿时间：2023-12-18 |
| 基金项目: |
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| Serum D -dimer, thromboxane B2 combined with 6-K-PGF1aprediction of deep vein thrombosis in lower limbs after joint replacement of artificial knee |
| ZHAO Yun,HU Wen-jin,ZHAO Xiao-hu |
| Tianjin Institute of Traditional Chinese Medicine Affiliated Hospital, Tianjin300120, China |
| Abstract: |
| Objective To explore the predictive value of serum D-dimer (D-D), thromboxane B2 (TXB2) combination 6-keto-prostaglandin F1a(6-K-PGF1a) for lower limbs deep vein thrombosis (DVT) after total knee arthroplasty (TKA). Methods 156 patients who plan to undergo TKA were selected, and they were divided into concurrent group and non-concurrent group according to whether postoperative lower limb DVT occurred. The serum levels of D-D, TXB2, 6-K-PGF1abefore and 24 hours after surgery were detected and compared between the two groups. The influencing factors of lower limb DVT after TKA was analyzed by Logistic regression, and the predictive value of the postoperative 24-hour serum D-D, TXB2 and 6-K-PGF1alevels of DVT in lower limbs after TKA was analyzed by the receiver operating characteristic (ROC) curve. Results The levels of serum D-D and TXB2 in concurrent group at 24 hours after surgery were higher than those in nonconcurrent group (P< 0.05), and the serum 6-K-PGF1alevel at 24 hours after surgery was lower than that in nonconcurrent group (P< 0.05). Logistic regression analysis showed that the levels of serum D-D, TXB2 and 6-K-PGF1a at 24 hours after surgery were the influencing factors for lower limb DVT after TKA (P< 0.05). The ROC curve analysis showed that the sensitivity and area under curve of serum D-D, TXB2, and 6-K-PGF1alevels to predict DVT of lower limbs after TKA were 94.23% and 0.925 respectively, which were higher than the independent prediction of each index (P< 0.05), and the specificity was basically consistent with the individual predictions of each indicator. Conclusion The levels of serum D-D, TXB2, 6-K-PGF1aat 24 hours after surgery have certain predictive value for lower limb DVT after TKA, but the combined predictive value of the three is higher. |
| Key words: D-dimer thromboxane B2 6-ketoprostaglandin F1a artificial knee joint replacement lower limb deep vein thrombosis |
