| 胡 玮,吴增晖,王 簕,许俊杰,张清顺,王 钊,刘 松,娄冬华.老年腰椎间盘突出症患者术后下肢深静脉血栓形成的影响因素及术前D-D、TM、Leptin联合应用的预测价值[J].,2023,(12):2280-2284 |
| 老年腰椎间盘突出症患者术后下肢深静脉血栓形成的影响因素及术前D-D、TM、Leptin联合应用的预测价值 |
| The Influencing Factors of Postoperative Lower Limb Deep Vein Thrombosis in Elderly Patients with Lumbar Disc Herniation and the Predictive Value of the Combined Application of Preoperative D-D, TM and Leptin |
| 投稿时间：2023-03-03 修订日期：2023-03-26 |
| DOI：10.13241/j.cnki.pmb.2023.12.014 |
| 中文关键词: 老年 腰椎间盘突出症 下肢深静脉血栓形成 D-D TM Leptin 预测价值 |
| 英文关键词: Elderly Lumbar disc herniation Lower limb deep vein thrombosis D-D TM Leptin Predictive value |
| 基金项目:广东省基础与应用基础研究基金项目（2021A1515012549） |
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| 中文摘要: |
| 摘要 目的：分析老年腰椎间盘突出症（LDH）患者术后下肢深静脉血栓形成（LDVT）的影响因素并探讨术前D-二聚体（D-D）、血栓调节蛋白（TM）、瘦素（Leptin）联合应用的预测价值。方法：选取2020年1月～2021年12月广州医科大学附属第三医院收治的412例接受腰椎椎间融合术（LIF）老年LDH患者，根据术后是否发生LDVT将其分为LDVT组和非LDVT组。收集老年LDH患者临床资料，采用酶联免疫吸附法检测术前血清D-D、TM、Leptin水平。采用多因素Logistic回归分析老年LDH患者LIF术后LDVT的影响因素，采用受试者工作特征（ROC）曲线分析术前血清D-D、TM、Leptin水平对老年LDH患者LIF术后LDVT的预测价值。结果：412例老年LDH患者LIF术后LDVT发生率为21.12%（87/412）。多因素Logistic回归分析显示，年龄增加、体质指数≥24 kg/m2、卧床时间≥7 d、D-D升高、TM升高、Leptin升高为老年LDH患者LIF术后LDVT的独立危险因素（P＜0.05）。ROC曲线分析显示，术前血清D-D、TM、Leptin水平单独与联合预测老年LDH患者LIF术后LDVT的曲线下面积分别为0.766、0.760、0.767、0.894，联合预测的曲线下面积大于D-D、TM、Leptin单独预测。结论：老年LDH患者LIF术后LDVT发生与年龄、体质指数、卧床时间和D-D、TM、Leptin有关，术前血清D-D、TM、Leptin水平联合预测老年LDH患者LIF术后LDVT的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the influencing factors of postoperative lower limb deep vein thrombosis (LDVT) in elderly patients with lumbar disc herniation (LDH) and to investigate the predictive value of the combined application of preoperative D-dimer (D-D), thrombomodulin (TM) and Leptin. Methods: 412 elderly LDH patients who underwent lumbar interbody fusion (LIF) were selected from the Third Affiliated Hospital of Guangzhou Medical University from January 2020 to December 2021, and they were divided into LDVT group and non-LDVT group according to whether LDVT occurred after surgery. Clinical data of elderly patients with LDH were collected. The preoperative serum D-D, TM and Leptin levels were detected by enzyme-linked immunosorbent assay. Multivariate Logistic regression was used to analyze the influencing factors of LDVT after LIF surgery in elderly patients with LDH, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of preoperative serum D-D, TM and Leptin levels on LDVT after LIF surgery in elderly patients with LDH. Results: The incidence rate of LDVT after LIF surgery in 412 cases of elderly patients with LDH was 21.12% (87/412). Multivariate Logistic regression analysis showed that increased age, body mass index ≥24 kg/m2, time in bed ≥7 d, elevated D-D, elevated TM and elevated Leptin were independent risk factors for LDVT after LIF surgery in elderly patients with LDH (P＜0.05). ROC curve analysis showed that the area under the curve of preoperative serum D-D, TM and Leptin levels alone and combined prediction the LDVT after LIF surgery in elderly patients with LDH were 0.766, 0.760, 0.767 and 0.894, respectively, and the area under the curve of combined prediction was greater than that of D-D, TM and Leptin alone prediction. Conclusion: The occurrence of LDVT after LIF surgery in elderly patients with LDH is related to age, body mass index, time in bed and D-D, TM, leptin, and the combination of preoperative serum D-D, TM, Leptin levels is of high value in predicting LDVT after LIF surgery in elderly patients with LDH. |
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