Value of limb vascular ultrasound and plasma D-dimer and fibrinogen in evaluating lower extremity deep venous thrombosis in stroke patients with paralysis
Objective To analyze the value of limb vascular ultrasound and plasma D-dimer(D-D)and fibrinogen in evaluating lower limb deep venous thrombosis(DVT)in stroke patients with paralysis.Methods A total of 91 stroke patients with hemiplegia admitted to the department of rehabilitation medicine at Suixi County Hospital in Anhui province from January 2019 to March 2023 were divided into the thrombosis group(n= 45)and the non-thrombosis group(n= 46)according to the presence or absence of lower extremity DVT.Clinical data,conditions,limb vascular ultrasound examination result,and laboratory indicators of the two groups were compared.The relationship between limb vascular ultrasound,plasma D-D and fibrinogen and lower extremity DVT in stroke patients with paralysis was analyzed.The value of limb vascular ultrasound andplasma D-D and fibrinogen in evaluating lower extremity DVT in stroke patients with paralysis was analyzed using the receiver operating characteristic(ROC)curve.Results The proportions of patients aged 60 or older,patients with the NIHSS score of 16 or higher at admission,patients with bed rest time of 14 days or longer,patients with grade 0～1 paralysis,patients with venous catheters and patients with abnormal echos of limb blood vessels in the thrombosis group were significantly higher than those in the non-thrombosis group(χ2 =4.837,8.004,5.166,9.570,6.721,15.182,P<0.05).The diameter of limb blood vessel in the thrombosis group was significantly larger than that in the non-thrombosis group,and blood flow velocity was significantly lower than that in the non-thrombosis group(t= 10.364,16.358,P<0.05).Plasma D-D and fibrinogen levels in the thrombosis group were significantly higher than those in the non-thrombosis group(t= 17.680,26.729,P<0.05).After correcting the confounding factors,it was found that large limb blood vessel diameter,low limb blood flow velocity and high plasma D-D and fibrinogen levels were independent risk factors for lower extremity DVT in stroke patients with paralysis(Waldχ2=14.608,9.960,5.994,16.484,27.016,P<0.05).ROC curve analysis found that the area under the curve and specificity of limb vascular ultrasound combined with plasma D-D and fibrinogen for evaluating lower extremity DVT in stroke patients with paralysis were 0.884 and 97.30%,higher than those of single evaluation.Conclusion Limb vascular ultrasound and plasma D-D and fibrinogen levels are closely related to lower extremity DVT in stroke patients with paralysis.The risk of DVT in stroke patients with paralysis can be identified in an early and specific manner through closely monitoring the patients'limb vascular ultrasound examination result and plasma D-D and fibrinogen levels.
Stroke with paralysisLimb vascular ultrasoundD-dimerFibrinogenLower extremity deep venous thrombosis
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