血清TM、P-selectin及血液流变学相关指标预测老年股骨转子间骨折术后深静脉血栓发生风险的价值

doi:10.3969/j.issn.1007-3205.2024.01.007

河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (1): 29-34.doi: 10.3969/j.issn.1007-3205.2024.01.007

血清TM、P-selectin及血液流变学相关指标预测老年股骨转子间骨折术后深静脉血栓发生风险的价值

1.江苏省连云港市东方医院骨科,江苏连云港 222042;2.江苏省连云港市东方医院急诊外科,江苏连云港 222042

出版日期:2024-01-25 发布日期:2024-01-31
作者简介:丁辉海（1980-），男，山东郯城人，江苏省连云港市东方医院副主任医师,医学学士，从事骨科疾病诊治研究。
基金资助:
江苏省科技计划项目基础研究计划（自然科学基金）（BK20191179）

Analysis of the value of serum TM, P-selectin and hemorheology indexes in predicting the risk of deep venous thrombosis after surgery for femoral intertrochanteric fracture in elderly patients

1.Department of Orthopaedics， Lianyungang Ortental Hospital, Jiangsu Province， Lianyungang
222042， China； 2.Department of Emergency Surgery， Lianyungang Oriental Hospital,
Jiangsu Province, Lianyungang 222042， China

Online:2024-01-25 Published:2024-01-31

摘要/Abstract

摘要： 目的探讨血清血栓调节蛋白（thrombomodulin,TM）、P-选择素（P-selectin）及血液流变学指标对老年股骨转子间骨折术后深静脉血栓（deep venous thrombosis,DVT）发生风险的预测价值。
方法收集老年股骨转子间骨折手术患者98例的临床资料开展回顾性研究，根据术后是否发生DVT分为DVT组30例和非DVT组68例。记录并比较2组一般资料、TM、P-selectin及血液流变学指标水平（全血低切黏度、全血高切黏度、全血中切黏度）。采用ROC分析TM、P-selectin及血液流变学指标预测患者术后发生DVT的价值，通过多因素Logistic回归分析明确患者术后发生DVT的危险因素。
结果 DVT组TM、P-selectin水平、全血低切黏度、全血高切黏度、全血中切黏度均高于非DVT组（P＜0.05）。经ROC分析结果显示，TM、P-selectin全血低切黏度、全血高切黏度、全血中切黏度均可用于老年股骨转子间骨折患者术后发生DVT的预测，曲线下面积分别为0.906、0.723、0.674、0.909、0.647（P＜0.05）。多因素Logistic回归分析结果显示，TM≥8.67 kU/L、P-selectin≥61.21 μg/L、全血低切黏度≥9.035 mPa·s、全血高切黏度≥4.725 mPa·s、全血中切黏度≥5.665 mPa·s是老年股骨转子间骨折患者术后发生DVT的危险因素（P＜0.05）。
结论 TM、P-selectin及血液流变学指标均可用于预测老年股骨转子间骨折术后DVT发生风险，TM、P-selectin及全血低切黏度、全血高切黏度、全血中切黏度水平较高的患者术后易发生DVT，提示临床应定期检测上述指标，及时给予抗凝治疗，以降低术后DVT发生风险。

关键词: 股骨颈骨折, 静脉血栓形成, 预测

Abstract: Objective To investigate the value of serum thrombomodulin (TM), P-selectin, and hemorheology indexes in predicting the risk of deep venous thrombosis (DVT) after surgery for femoral intertrochanteric fractures in the elderly.
Methods Clinical data of 98 elderly patients undergoing surgery for femoral intertrochanteric fracture were collected for retrospective study. The patients were divided into DVT group (n=30) and non-DVT group (n=68) according to whether postoperative DVT occurred. General data, TM, P-selectin and hemorheology indexes ［whole blood low shear viscosity (WBLSV), whole blood high shear viscosity (WBHSV), whole blood medium shear viscosity (WBMSV)］ of the two groups were recorded and compared. The value of TM, P-selectin and hemorheology indexes in predicting postoperative DVT was analyzed by receiver operating characteristic (ROC), and the risk factors of postoperative DVT were determined by multivariate Logistic regression analysis.
Results The levels of TM, P-selectin, WBLSV, WBHSV, and WBMSV in DVT group were higher than those in non-DVT group (P＜0.05). ROC analysis showed that TM, P-selectin,WBLSV, WBHSV, and WBMSV could all be used for predicting postoperative DVT in elderly patients with intertrochanteric fracture, and the areas under the ROC curve (AUC) were 0.906, 0.723, 0.674, 0.909, and 0.647, respectively (all P＜0.05). The results of multivariate Logistic regression analysis showed that TM ≥8.67 kU/L, P-selectin≥61.21 μg/L, WBLSV ≥9.035 mPa·s, WBHSV ≥4.725 mPa·s, WBMSV ≥5.665 mPa·s were risk factors for postoperative DVT in elderly patients with intertrochanteric fracture (P＜0.05).
Conclusion TM, P-selectin and hemorheology indexes can all be used to predict the risk of DVT in elderly patients with intertrochanteric fracture. Patients with high levels of TM, P-selectin,WBLSV, WBHSV, and WBMSV are more likely to develop DVT after surgery, suggesting that these indexes should be tested regularly and anticoagulation therapy should be given in time, to reduce the risk of postoperative DVT.

Key words: femoral neck fractures, venous thrombosis, prediction

丁辉海1, 崔建国2, 韩成相1. 血清TM、P-selectin及血液流变学相关指标预测老年股骨转子间骨折术后深静脉血栓发生风险的价值 [J]. 河北医科大学学报, 2024, 45(1): 29-34.

DING Hui-hai1, CUI Jian-guo2, HAN Cheng-xiang1. Analysis of the value of serum TM, P-selectin and hemorheology indexes in predicting the risk of deep venous thrombosis after surgery for femoral intertrochanteric fracture in elderly patients [J]. Journal of Hebei Medical University, 2024, 45(1): 29-34.

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血清TM、P-selectin及血液流变学相关指标预测老年股骨转子间骨折术后深静脉血栓发生风险的价值

Analysis of the value of serum TM, P-selectin and hemorheology indexes in predicting the risk of deep venous thrombosis after surgery for femoral intertrochanteric fracture in elderly patients

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