|
Abstract Objective To explore the predictive value of D-dimer(D-D) combined with other blood indicators in the formation of deep venous thrombosis(DVT) after spinal degenerative surgery.Methods The clinical data of 583 patients with spinal degenerative surgery received from October 2017 to December 2020 were collected continuously.The patients were divided into two groups according to whether DVT occurred after surgery.There were 60 cases in DVT group,including 28 males and 32 females,with an average age of(65±10)years.There were 523 cases in non-DVT group,including 269 males and 254 females,with an average of(63±12)years.The general clinical data of the two groups were recorded.The levels of five items of coagulation,D-D,fibrin/fibrinogen degradation products(FDP),C-reactive protein(CRP),procalcitonin(PCT) and interleukin-6(IL-6) were detected 3 days after surgery.The indicators with statistical differences between the two groups were fitted by logistic regression.The diagnostic efficacy was analyzed by receiver operating characteristic(ROC) curve,and area under curve(AUC) was calculated to estimate the predictive diagnostic value of DVT after spinal degenerative surgery.Results (1)The levels of D-D,FDP and CRP in DVT group were significantly higher than those in non DVT group 3 days after operation(P<0.05).(2)ROC curve analysis showed that the AUC of D-D,FDP and CRP in predicting the diagnosis of DVT were 0.881(95%CI:0.829~0.933),0.864(95%CI:0.809~0.919) and 0.815(95%CI:0.759~0.870),respectively.The AUC of D-D,FDP and CRP in predicting the diagnosis of DVT was 0.912(95%CI:0.861~0.963),the sensitivity was 76.67%,and the specificity was 90.00%,which were higher than that of the three alone.Conclusion The combined detection of D-D,FDP and CRP can improve the early diagnosis efficiency of the three independent detection for DVT,and has certain judgment value for the prediction diagnosis of DVT formation after spinal degeneration surgery.
|
|
|
|
|
[1]Heit JA,Spencer FA,White RH.The epidemiology of venous thromboembolism[J].J Thromb Thrombolysis,2016,41(1):3-14.
[2]Ghosh N,Garg I,Srivastava S,et al.Influence of integrins on thrombus formation:A road leading to the unravelling of DVT[J].Mol Cell Biochem,2021,476(3):1489-1504.
[3]Wang H,Kandemir U,Liu P,et al.Perioperative incidence and locations of deep vein thrombosis following specific isolated lower extremity fractures[J].Injury,2018,49(7):1353-1357.
[4]Jain A,Hassanzadeh H,Puvanesarajah V,et al.Incidence of perioperative medical complications and mortality among elderly patients undergoing surgery for spinal deformity:Analysis of 3519 patients[J].J Neurosurg Spine,2017,27(5):534-539.
[5]Wang H,Pei H,Ding W,et al.Risk factors of postoperative deep vein thrombosis(DVT) under low molecular weight heparin(LMWH) prophylaxis in patients with thoracolumbar fractures caused by highenergy injuries[J].J Thromb Thrombolysis,2021,51(2):397-404.
[6]Tran HA,Gibbs H,Merriman E,et al.New guidelines from the thrombosis and haemostasis society of Australia and New Zealand for the diagnosis and management of venous thromboembolism[J].Med J Aust,2019,210(5):227-235.
[7]Ono Y,Hayakawa M,Maekawa K,et al.Fibrin/fibrinogen degradation products(FDP) at hospital admission predict neurological outcomes in out of hospital cardiac arrest patients[J].Resuscitation,2017(111):62-67.
[8]Moutachakkir M,Lamrani Hanchi A,Baraou A,et al.Immunoanalytical characteristics of C-reactive protein and high sensitivity C-reactive protein[J].Ann Biol Clin(Paris),2017,75(2):225-229.
[9]Lurie JM,Png CYM,Subramaniam S,et al.Virchow's triad in "silent" deep vein thrombosis[J].J Vasc Surg Venous Lymphat Disord,2019,7(5):640-645.
[10]Zeeshan M,Khan M,O'keeffe T,et al.Optimal timing of initiation of thromboprophylaxis in spine trauma managed operatively:A nationwide propensity-matched analysis of trauma quality improvement program[J].J Trauma Acute Care Surg,2018,85(2):387-392.
[11]Kim HJ,WalcottSapp S,Adler RS,et al.Thromboembolic complications following spine surgery assessed with spiral CT scans:DVT/PE following spine surgery[J].Hss J,2011,7(1):37-40.
[12]Buitrago L,Zafar H,Zhang Y,et al.Dominant role of αⅡbβ3 in platelet interactions with cross-linked fibrin fragment D-dimer[J].Blood Adv,2020,4(13):2939-2949.
[13]Wang Z,Wang B,Li X,et al.Metabolic syndrome,high-sensitivity C-reactive protein levels and the risk of new-onset atrial fibrillation:Results from the kailuan study[J].Nutr Metab Cardiovasc Dis,2021,31(1):102-109.
[14]Masuda M,Ueta T,Shiba K,et al.Ddimer screening for deep venous thrombosis in traumatic cervical spinal injuries[J].Spine J,2015,15(11):2338-2344.
[15]Mitchell AM,Nordenholz KE,Kline JA.Tandem measurement of D-dimer and myeloperoxidase or C-reactive protein to effectively screen for pulmonary embolism in the emergency department[J].Acad Emerg Med,2008,15(9):800-805.
[16]Madoiwa S,Kitajima I,Ohmori T,et al.Distinct reactivity of the commercially available monoclonal antibodies of D-dimer and plasma FDP testing to the molecular variants of fibrin degradation products[J].Thromb Res,2013,132(4):457-464.
[17]Moresco RN,Júnior RH,Cláudio Rosa Vargas L,et al.Association between plasma levels of D-dimer and fibrinogen/fibrin degradation products(FDP) for exclusion of thromboembolic disorders[J].J Thromb Thrombolysis,2006,21(2):199-202.
[18]Tian B,Song C,Li H,et al.The significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for predicting venous thromboembolism:a prospective,single center study[J].J Thorac Dis,2018,10(4):2223-2230. |
|
|