CAJ | 학술논문

目的：探讨全髋关节置换术后血浆D-二聚体（DD）及纤维蛋白降解产物（FDPs）浓度的动态变化特点及其对早期诊断下肢深静脉血栓形成（DVT）的价值。方法2011年7月至2012年5月126例髋关节置换术患者，对其资料进行回顾性分析，其中男56例，女70例；年龄38～92岁，平均75.6岁。根据术后4 d下肢超声检测结果，将患者分为血栓组32例，非血栓组94例。采用免疫散射比浊法测定患者入院时、术后1 d、4 d、7 d血浆DD及FDPs浓度，将相关检测结果行统计学分析，结合超声检查结果，分析比较血浆 DD、FDPs 两个检测指标及联合检测结果的敏感性。结果126例关节置换术患者血浆 DD及FDPs值术后均有不同程度的升高。术后不同时间点血浆DD及FDPs浓度均高于未发生DVT的患者，差异有统计学意义（P＜0.05）。FDPS 术后4、7 d明显增加（P＜0.01）。与基础值比较，两组DD术后各时间点均明显升高，于术后1 d达到峰值：未发生血栓组（2469.9±508.3）μg/L，血栓组（3472.2±690.7）μg/L（P＜0.01）；FDPs术后4、7 d明显增加，且7 d值较4 d值增高明显：术后7 d，非血栓组（3673.4±480.7）μg/L，血栓组（4571.9±864.3）μg/L（P＜0.01）。术后4 d，DD 结合FDPs检测的敏感性和特异性分别达到95.3%和94.1%。结论全髋关节置换术后患者血浆DD及FDPs浓度的动态监测对DVT的早期诊断具有重要价值。
목적：탐토전관관절치환술후혈장D-이취체（DD）급섬유단백강해산물（FDPs）농도적동태변화특점급기대조기진단하지심정맥혈전형성（DVT）적개치。방법2011년7월지2012년5월126례관관절치환술환자，대기자료진행회고성분석，기중남56례，녀70례；년령38～92세，평균75.6세。근거술후4 d하지초성검측결과，장환자분위혈전조32례，비혈전조94례。채용면역산사비탁법측정환자입원시、술후1 d、4 d、7 d혈장DD급FDPs농도，장상관검측결과행통계학분석，결합초성검사결과，분석비교혈장 DD、FDPs 량개검측지표급연합검측결과적민감성。결과126례관절치환술환자혈장 DD급FDPs치술후균유불동정도적승고。술후불동시간점혈장DD급FDPs농도균고우미발생DVT적환자，차이유통계학의의（P＜0.05）。FDPS 술후4、7 d명현증가（P＜0.01）。여기출치비교，량조DD술후각시간점균명현승고，우술후1 d체도봉치：미발생혈전조（2469.9±508.3）μg/L，혈전조（3472.2±690.7）μg/L（P＜0.01）；FDPs술후4、7 d명현증가，차7 d치교4 d치증고명현：술후7 d，비혈전조（3673.4±480.7）μg/L，혈전조（4571.9±864.3）μg/L（P＜0.01）。술후4 d，DD 결합FDPs검측적민감성화특이성분별체도95.3%화94.1%。결론전관관절치환술후환자혈장DD급FDPs농도적동태감측대DVT적조기진단구유중요개치。
Objective To investigate the total hip arthroplasty D-dimer (DD) and fibrin degradation products (FDPS) concentration and its effect on the dynamic changes of the early diagnosis of deep venous thrombosis (DVT) value. Methods From July 2011 to May 2012 126 cases of hip replacement patients, their data were retrospectively analyzed, including 56 males and 70 females; aged 38 to 92 years, mean 75.6 years old. According to 7 days after lower extremity B-test results, patients were divided into thrombus group of 32 patients, 94 cases of non-thrombotic group . By immune nephelometry were measured on admission, postoperative 1d, 4d, 7d plasma D-dimer and fibrin degradation products (FDPS) concentration, the relevant test results OK statistical analysis, combined with B-test results, analysis comparison of plasma DD, FDPS two detection index and joint detection sensitivity of the results. Results 126 cases of arthroplasty patients with DD and FDPS values increased in varying degrees postoperatively . Different time points after DD and FDPS plasma concentrations were higher than those without DVT patients, the difference was statistically significant (P<0.05). FDPS after 4, 7 days significantly increased (P<0.01). Compared with baseline in both groups at each time point after DD were significantly increased, peaking at 1 day after surgery : no thrombus group (2469.9±508.3) μg/L, thrombosis group (3472.2 ± 690.7)μg/L (P<0.01);FDPS increased significantly after 4, 7 days and 7 days values increased significantly compared with the value of 4 days:Non-thrombosis group (3673.4±480.7)μg/L, thrombosis group.Conclusion Patients with total hip arthroplasty plasma D-dimer and fibrin degradation product concentration for dynamic monitoring of early diagnosis of DVT has important value.