The application value of presurgical serum chemokine(C-C motif)ligand 3 and P-selectin levels in predicting lower limb deep venous thrombosis following the pelvic fracture surgery
Objective:To explore the applied value of presurgical serum levels of chemokine(C-C motif)ligand 3(CCL3)and P-selec-tin in predicting lower limb deep venous thrombosis(LDVT)following the pelvic fracture surgery.Methods:The patients with pelvic frac-tures scheduled for being treated by surgery were selected and enrolled in the study,and the information including age,gender,body mass index,whether combined with hypertension,and whether combined with diabetes was extracted from the Electronic Medical Record System(EMRS).On presurgical day 1,the blood was drawn from the vein,and the serum levels of total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),C-reactive protein(CRP),hemoglobin(Hb),CCL3 and P-selectin,the plasma levels of fibrinogen(FIB)and D-dimer,the activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)were detected.On postsurgical day 1,7 and 14,the incidence of LDVT was assessed,respectively.The patients were divided into LDVT group and non-LDVT group according to whether LDVT was found after the surgery.The single-factor analysis was con-ducted on the extracted information of patients in the 2 groups,followed by multi-factor logistic regression analysis on the factors with statis-tically significant differences between the 2 groups.Furthermore,the applied values of influencing factors in predicting LDVT following the pelvic fracture surgery were analyzed and evaluated by using receiver operating characteristic(ROC)curve.Results:One hundred and nine-ty-six patients with pelvic fracture were included in the final analysis,38 cases in LDVT group and 158 cases in non-LDVT group.The sin-gle-factor analysis showed that the differences were statistically significant between LDVT group and non-LDVT group in the serum levels of HDL-C,CRP,Hb,CCL3 and P-selectin,as well as the plasma levels of FIB and D-dimer(1.04±0.22 vs 1.21±0.35 mmol/L,t=2.858,P=0.005;36.18±3.72 vs 23.48±2.69 mg/L,t=24.116,P=0.000;98.43±9.65 vs 91.28±9.21 g/L,t=4.257,P=0.000;15.65±2.13 vs 12.57±1.76 pg/mL,t=9.283,P=0.000;45.43±5.11 vs 38.57±4.06 ng/mL,t=8.871,P=0.000;4.57±0.53 vs 3.72±0.41 g/L,t=10.804,P=0.000;978.64±98.73 vs 467.45±48.26 µg/L,t=46.239,P=0.000).The logistic regression analy-sis revealed that the presurgical serum levels of CCL3 and P-selectin were the risk factors for LDVT in patients with pelvic fracture after the surgery(β=0.921,P=0.008,OR=2.513;β=0.730,P=0.001,OR=2.076).The results of ROC curve analysis showed that the area under the ROC curve of presurgical serum levels of CCL3 and P-selectin in predicting LDVT after the pelvic fracture surgery was 0.935(P=0.000).Conclusion:The presurgical serum levels of CCL3 and P-selectin are the risk factors for LDVT in patients with pelvic frac-ture after the surgery,and their combination displays high application value in predicting LDVT after the pelvic fracture surgery.
万方数据
维普
