摘要
目的 研究凝血四项检查[包括凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、纤维蛋白原(FIB)和凝血酶时间(TT)]结合D-二聚体(D-D)、血小板计数(PLT)诊断急性下肢深静脉血栓(DVT)的应用价值.方法 选取2021年6月至2024年5月就诊于泉州市第一医院血管外科,发病14 d以内,以下肢肿痛为主诉并确诊下肢DVT的无明显诱因患者65例的临床资料进行回顾分析.并选取同时期就诊于血管外科非DVT的下肢疾病患者70例作为疾病对照.比较2组患者间PT、APTT、FIB、TT、D-D、PLT水平的差异.受试者工作特征(ROC)曲线评估PT、FIB、D-D筛查DVT的能力,并进行性能评价.结果 DVT组PT、FIB、D-D水平明显高于非DVT组,差异具有统计学意义(P＜0.001).ROC分析显示PT、FIB、D-D均可有效地筛查DVT,曲线下面积(AUC)分别为0.794、0.722、0.998.单独D-D筛查DVT的特异性和阳性预测值最好,D-D结合PT或FIB时可达到灵敏度和阴性预测值100％.结论 以下肢肿痛为主诉的下肢疾病患者中,PT、FIB、D-D均可有效筛查DVT.当单独选择D-D指标时筛查DVT的诊断性能最好,其水平低于1.27 mg/L时可基本排除DVT的可能.
Abstract
Objective To tnvestigate the diagnostic value of combining four coagulation tests:prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),and thrombin time(TT)with D-dimer(D-D)and platelet(PLT)in the assessment of lower extremity deep vein thrombosis(DVT).Methods A retrospective analysis was conducted on the clinical data of 65 patients who visited the department of vascular surgery at Quanzhou First Hospital from June 2021 to May 2024 and were diagnosed with lower extremity deep vein thrombosis(DVT)within 14 days of onset,with lower limb swelling and pain as the main complaints.Additionally,70 patients with lower limb diseases who received non-DVT treatment in vascular surgery at the same hospital during the same period were selected as disease controls.The differences in PT,APTT,FIB,TT,D-D,and PLT levels between the two groups of patients were compared.Receiver operating characteristic curve(ROC)analysis was used to evaluate the ability of PT,FIB,and D-D to screen for DVT,and performance evaluations were conducted.Results The levels of PT,FIB,and D-D in the DVT group were significantly higher than those in the non-DVT group,and the differences were statistically significant(P＜0.001).ROC analysis demonstrated that PT,FIB,and D-D can effectively screen for DVT,with area under the curve(AUC)values of 0.794,0.722,and 0.998,respectively.The specificity and positive predictive value of D-D alone in screening for DVT were the highest,while the sensitivity and negative predictive value could reach 100.00％when D-D was combined with either PT or FIB.Conclusion Among patients with lower limb diseases who complain of lower limb swelling and pain,PT,FIB,and D-D can all effectively screen for DVT.The diagnostic performance for screening DVT is optimal when the D-D index is considered separately,and the possibility of DVT can be virtually ruled out when its level is below 1.27 mg/L.
维普
万方数据