[1]李 虎.血浆纤维蛋白单体水平检测对下肢骨折术后静脉栓塞的预测价值[J].现代检验医学杂志,2017,32(05):133-136.[doi:10.3969/j.issn.1671-7414.2017.05.017]
　LI Hu.Predictive Value of Plasma Fibrin Monomer Level on Postoperative Venous Thromboembolism in Fracture of Lower Limb[J].Journal of Modern Laboratory Medicine,2017,32(05):133-136.[doi:10.3969/j.issn.1671-7414.2017.05.017]
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血浆纤维蛋白单体水平检测对下肢骨折术后静脉栓塞的预测价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年05期
页码:
133-136
栏目:
检验与临床
出版日期:
2017-11-02

文章信息/Info

Title:
Predictive Value of Plasma Fibrin Monomer Level on Postoperative Venous Thromboembolism in Fracture of Lower Limb
文章编号:
1671-7414(2017)05-133-04
作者:
李 虎
上海市宝山区罗店医院检验科,上海 201908
Author(s):
LI Hu
Department of Clinical Laboratory,Shanghai Baoshan Luodian Hospital,Shanghai 201908,China
关键词:
纤维蛋白单体;  静脉血栓栓塞症;  骨折;  D-二聚体
分类号:
R683.42; R446.112
DOI:
10.3969/j.issn.1671-7414.2017.05.017
文献标志码:
A
摘要:
目的 探讨血浆纤维蛋白单体水平对下肢骨折术后静脉血栓栓塞症(VTE)的预测价值。方法 回顾性分析2016年1～12月期间行下肢骨折内固定术的126例患者的临床资料,包括围手术期的血浆凝血酶原时间(PT),活化的部分凝血活酶时间(APTT),凝血酶时间(TT),纤维蛋白原(Fib),D-二聚体(DD)和纤维蛋白单体(FM),并根据下肢彩色多普勒超声检查和随访结果分为VTE组(n=19)和无VTE组(n=107)。比较患者手术前后各凝血纤溶指标的变化,通过受试者工作曲线下的面积(AUC)评价各指标对术后VTE形成的预测价值。结果 ①所有患者术后的APTT,Fib,DD和FM均显著升高,差异均有统计学意义(F=3.550～-9.223,均P<0.05),其中FM在术后第1天开始即显著升高,后逐渐降低。②两组术前的APTT,Fib,DD和FM比较,差异无统计学意义(F=0.652～1.120,均P>0.05)。与无VTE组相比,VTE组的术后第1,5天的FM均显著升高,差异均有统计学意义(t=2.548～2.883,P<0.05)。③在术后第3天的APTT,Fib,DD和FM四个指标中, FM的AUC和Youden指数最大,分别为0.713(95%CI:0.620～0.823)与0.399。结论 下肢骨折术后存在凝血与纤溶系统的活化,术后第3天的血浆FM水平对术后VTE的形成具有较高的预测价值,效果优于DD。
Abstract:
Abstract:Objective To investigate the predictive value of plasma fibrin monomer(FM)level on postoperative venous thromboembolism(VTE)in fracture of lower limb.Methods Retrospectively analyzed the clinical data of 126 patients underwent internal fixation of lower limb fracture from January to December 2016,including perioperative plasma prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib),D-dimer(DD)and FM.And all patients were divided into VTE group(n=19)and non-VTE group(n=107)according to the venous color Doppler ultrasonography of lower limb and follow-up result.The change of coagulation and fibrinolysis indexes were compared before and after operation,and the area under the receiver operating characteristic curve(AUC)was performed to evaluate these indicators'predictive value for postoperative VTE. Results ①APTT,Fib,DD and FM increased significantly after operation in all patients(F=3.550～9.223,all P<0.05).Among them,FM increased significantly at 1d after operation,then gradually decreased.②There were no significant differences in APTT,Fib,DD and FM before operation between two groups(F=0.652～1.120,all P>0.05).Compared with non-VTE group,FM at 1,3 and 5d after operation increased significantly(t=2.548～2.883,all P<0.05),in which the difference of each index were largest at 3d after operation. ③In four indexes including APTT,Fib,DD and FM at 3d after operation,the AUC and Youden index ofFM were largest [0.713(95%CI:0.620 ～ 0.823)and 0.399].Conclusion There were coagulation and fibrinolysis system activated in fracture of lower limb after operation.Plasma FM at 3d after operation had highpredictive value of postoperative VTE,and its effect was better than DD.

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备注/Memo

备注/Memo:
作者简介:李 虎(1981-),男,本科,检验技师,主要从事临床检验学的研究,E-mail:lihu828@126.com。
更新日期/Last Update: 1900-01-01