摘要
目的 分析血浆血磷脂酸(LPA)、转化生长因子β1(TGF-β1)和D-二聚体(D-D)检测对全膝关节置换术后下肢深静脉血栓(DVT)诊断的价值.方法 回顾性分析2021年5月至2023年10月于山西省荣军医院行全膝关节置换术的 89例患者的临床资料,按照术后彩色多普勒超声结果分为非DVT组(n=69)和DVT组(n=20).比较两组血浆LPA、TGF-β1 和D-D水平,比较两组组临床资料(年龄、性别、运动、吸烟史、BMI、家族史、采取血栓预防措施),采用多元Logistic回归分析影响影响全膝关节置换术后DV发生的危险因素,采用ROC曲线分析血浆LPA、TGF-β1和D-D单一、联合对全膝关节置换术后DVT的诊断价值.结果 DVT组血浆LPA、TGF-β1和D-D均显著高于非DVT组,差异有统计学意义(P<0.05);两组年龄、性别、运动、吸烟史、BMI和家族史比较差异无统计学意义(P>0.05).两组的采取血栓预防措施比较差异有统计学意义(P<0.05);多元Logistic回归分析结果显示:未采取血栓预防措施、血浆LPA(<10 μmol/L,>140 μmol/L)、TGF-β1(<10 pg/mL,>100 pg/mL)、D-D(>0.5 mg/L)均为影响全膝关节置换术后DV发生的危险因素(P<0.05);血浆LPA+TGF-β1+D-D联合诊断全膝关节置换术后DVT的AUC为0.896,高于血浆LPA、TGF-β1和D-D单独检测(P<0.05).结论 血浆LPA、TGF-β1、D-D水平在全膝关节置换术后DVT发生患者中呈高表达,且三指标联合检测可提高全膝关节置换术后DVT的诊断效果.
Abstract
Objective To Analyzing the diagnostic value of plasma phosphatidic acid(LPA),transforming growth factor beta 1(TGF-β1),and D-dimer(D-D)detection for deep vein thrombosis(DVT)in the lower limbs after total knee arthroplasty.Methods The clinical data of 89 patients who underwent total knee arthroplasty at Shanxi Rongjun Hospital from May 2021 to October 2023 were retrospectively analyzed.Based on the results of postoperative color Doppler ultrasound,the patients were divided into two groups:the non-DVT group(n=69)and the DVT group(n=20).Plasma levels of LPA,TGF-β1,and D-D were com-pared between the two groups.The clinical data(age,gender,exercise,smoking history,BMI,family his-tory,and thrombosis prevention measures)were compared between the two groups.Multivariate logistic re-gression analysis was conducted to identify the risk factors affecting the occurrence of DVT after total knee ar-throplasty.The ROC curve was used to analyze the diagnostic value of single and combined plasma LPA,TGF-β1,and D-D for DVT after total knee arthroplasty.Results The levels of plasma LPA,TGF-β1,and D-D in the DVT group were significantly higher than those in the non-DVT group(P<0.05).There was no significant difference in age,gender,exercise,smoking history,BMI,and family history between the two groups(P>0.05).There was a significant difference in the prevention of thrombosis between the two groups(P<0.05).Multivariate logistic regression analysis showed that no thrombosis prevention measures,plasma LPA(140 μmol/L),TGF-β1(100 pg/mL),and D-D(>0.5 mg/L)were all risk factors for DVT after total knee arthro-plasty(P<0.05).The AUC of plasma LPA+TGF-β1+D-D in the diagnosis of DVT after total knee arthroplasty was 0.896,which was higher than that of plasma LPA,TGF-β1,and D-D alone(P<0.05).Conclusion The levels of plasma LPA,TGF-β1,and D-D were found to be highly expressed in patients with DVT after total knee arthroplasty.Combining the detection of all three markers could enhance the diagnostic accuracy for DVT following total knee arthroplasty.
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