| 高 彬,郑铁钢,刘宝平,徐文彦,高 岩,张翠梅.C反应蛋白、D-二聚体及Wells评分与脊柱骨折患者术后深静脉血栓的关系及其诊断价值分析[J].,2021,(11):2164-2168 |
| C反应蛋白、D-二聚体及Wells评分与脊柱骨折患者术后深静脉血栓的关系及其诊断价值分析 |
| The Relationship between C-reactive Protein, D-dimer and Wells Score and Postoperative Deep vein Thrombosis in Spinal Fracture Patients and Analysis Its Diagnostic Value |
| 投稿时间：2020-11-24 修订日期：2020-12-19 |
| DOI：10.13241/j.cnki.pmb.2021.11.036 |
| 中文关键词: C反应蛋白 D-二聚体 Wells评分 脊柱手术 深静脉血栓 |
| 英文关键词: C-reactive protein D-dimer Wells score Spinal surgery Deep vein thrombosis |
| 基金项目:河北省2020年度医学科学研究课题计划项目（20201608） |
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| 中文摘要: |
| 摘要 目的：探讨C反应蛋白（CRP）、D-二聚体（D-D）及Wells评分与脊柱骨折患者术后深静脉血栓（DVT）的关系，分析三者对脊柱骨折患者术后DVT的诊断价值。方法：选择2017年2月至2019年9月期间我院骨科收治的351例脊柱骨折患者，根据术后是否发生DVT将患者分为DVT组（59例）和非DVT组（292例）。比较DVT组和非DVT组术后1d、术后3d、术后7d、术后14d的CRP、D-D水平及Wells评分。采用Spearman秩相关分析CRP、D-D水平与Wells评分相关性。采用受试者工作特征（ROC）曲线分析CRP、D-D、Wells评分单项及联合三项指标对脊柱骨折患者术后DVT的诊断价值。结果：两组术后1d、术后3d、术后7d、术后14d的CRP、D-D水平以及Wells评分均呈先升高后降低变化趋势（P＜0.05），DVT组术后3d、术后7d、术后14d的CRP、D-D水平以及Wells评分高于非DVT组（P＜0.05）。Spearman秩相关分析结果显示DVT组CRP、D-D水平与Wells评分均呈正相关（P＜0.05）。ROC曲线分析结果显示术后7d的D-D、CRP、Wells评分诊断脊柱骨折患者术后DVT的曲线下面积（AUC）分别为0.823、0.785、0.769，高于术后3d和术后14d；术后7d的CRP、D-D和Wells评分联合诊断脊柱骨折患者术后DVT的AUC为0.928，高于各指标单独诊断。结论：CRP、D-D水平及Wells评分均与脊柱骨折患者术后DVT有关，术后7d CRP、D-D和Wells评分联合诊断术后DVT的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between C-reactive protein (CRP), D-dimer(D-D) and Wells score and postoperative deep vein thrombosis (DVT) in spinal fracture patients, and analyze the diagnostic value of the three for postoperative DVT in spinal fracture patients. Methods: 351 cases of spinal fracture patients admitted to the department of Orthopedics of our hospital from February 2017 to September 2019 were selected, and the patients were divided into DVT group (59 cases) and non-DVT group (292 cases) according to the occurrence of postoperative DVT. The levels of CRP, D-D and Wells score were compared between DVT group and non DVT group at 1d, 3d, 7d and 14d after operation. Spearman rank correlation analysis was used to analyze the correlation between CRP, D-D and Wells score. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of CRP, D-D and Wells score in the diagnosis of postoperative DVT in spinal fracture patients. Results: The levels of CRP and D-D and Wells score first increased and then decreased in both groups 1d, 3d, 7d and 14d after operation (P < 0.05). The serum levels of CRP, D-D and Wells scores of DVT group were higher than those of the non-DVT group at 3d, 7d and 14d after operation (P < 0.05). Spearman rank correlation analysis showed that levels of serum CRP and D-D in DVT group were positively correlated with Wells score (P<0.05). ROC analysis results showed that the area under the curve (AUC) of D-D, CRP and Wells score for diagnosing postoperative DVT in patients with spinal fracture 7d after operation were 0.823, 0.785, and 0.769 respectively, higher than that of 3d and 14d after operation. Combined with CRP, D-D and Wells score 7d after operation, the AUC of postoperative DVT in patients with spinal fracture was 0.928, which was higher than the index diagnosis alone. Conclusion: CRP, D-D level and Wells score were all related to postoperative DVT of spinal fracture patients, combined with CRP, D-D and Wells score 7d after operation, DVT of spinal fracture patients could be better diagnosed. |
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