摘要
目的 探究血小板与淋巴细胞比值(PLR)联合血栓弹力图(TEG)对自发性脑出血患者术后下肢深静脉血栓(LDVTE)的预测价值.方法 选取2020年6月—2023年6月新疆医科大学第一附属医院神经外科收治自发性脑出血手术患者83例临床资料;根据患者LDVTE发生情况分为血栓组(n=19)和非血栓组(n=64);比较患者PLR值及TEG参数[凝血形成速率(α角度)、凝血最终强度(MA值)、血凝块开始形成时间(K值)、凝血反应时间(R值)];分析PLR与TEG相关参数的相关性;绘制各指标对LDVTE预测价值的受试者工作曲线(ROC)并进行比较.结果 血栓组患者PLR值、α角度和MA值均显著高于非血栓组(t/P=6.225/＜0.001,4.290/＜0.001,3.596/＜0.001),K值和R值显著低于非血栓组(t/P=3.847/＜0.001,3.281/0.002);PLR与α角度、MA值之间呈正相关(r/P=0.402/＜0.001,0.624/＜0.001);与 K 值呈负相关(r/P=-0.320/0.003);与 R 值无显著相关性(r/P=-0.104/0.349);PLR、α角度、MA值、K值、R值及五项联合预测患者术后发生LDVTE的AUC分别为0.789、0.782、0.792、0.795、0.737、0.919,五项联合优于各自单独预测效能(Z/P=2.627/0.009,3.007/0.002,1.999/0.046,2.092/0.036,3.256/0.001).结论 PLR和TEG均与自发性脑出血术后患者LDVTE有关,可作为预测LDVTE发生的参考指标.
Abstract
Objective Exploring the predictive value of platelet-to-lymphocyte ratio(PLR)combined with throm-boelastography(TEG)for postoperative deep vein thrombosis(LDVTE)in patients with spontaneous intracerebral hemor-rhage.Methods The clinical data of 83 patients with spontaneous intracerebral hemorrhage admitted to the Department of Neurology of the First Affiliated Hospital of Xinjiang Medical University from June 2020 to June 2023 were continuously se-lected.According to the occurrence of LDVTE,the patients were divided into thrombosis group(n=19)and non-thrombo-sis group(n=64).PLR values and TEG data were compared and analyzed.The correlation between PLR and TEG related in-dicators was analyzed.The receiver operating curve(AUC)of PLR,TEG and their combination was drawn and the predictive value of each index was evaluated.Results The PLR value,α Angle and MA value in the thrombosis group were signifi-cantly higher than those in the non-thrombosis group(t/P=6225/＜0.001,4290/＜0.001,3.596/＜0.001),K value and R val-ue were significantly lower than those of non-thrombosis group(t/P=3.847/＜0.001,3 281/0.002);PLR was positively corre-lated with α Angle and MA(r/P=0.402/＜0.001,0.624/＜0.001).And negatively correlated with K value(r/P=-0320/0.003).There was no significant correlation with R value(r/P=-0.104/0.349).The AUC of PLR,α Angle,MA value,K value,R value and the combination of the five factors to predict LDVTE after surgery were 0.789,0.782,0.792,0.795,0.737,0.919,respectively,and the combination of the five factors was significantly better than their individual prediction efficacy(Z/P=-2.627/0.009,-3.007/0.002,-1.999/0.046,-2.092/0.036,-3.256/0.001).Conclusion PLR and TEG are both related to LDVTE in patients after cerebral hemorrhage surgery,which can be used as reference indicators to predict the occurrence of LDVTE.PLR combined with TEG has a higher predictive value.
基金项目
新疆维吾尔自治区自然科学基金资助项目(2022D01C224)
维普
万方数据