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投稿时间：2024-10-18 网络发布日期：2025-02-20
投稿时间：2024-10-18 网络发布日期：2025-02-20
中文摘要: 目的 探讨彩超技术与血清中趋化因子配体3（CCL3）及P选择素（P-selectin）水平相结合的方法，对于诊断髋部骨折患者术后下肢深静脉血栓（LEDVT）的价值。方法 选取2022年9月至2024年9月西安高新医院收治的80例髋部骨折并发LEDVT患者为LEDVT组，80例髋部骨折无LEDVT患者为无LEDVT组，另选同期80例体检健康者为对照组。比较3组血清中CCL3、P-selectin的水平；通过彩色多普勒血流显像（CDFI）测量股总静脉（CFV）、股深静脉（DFV）内径，并计算皮下组织增厚度。多因素logistic回归分析髋部骨折患者发生LEDVT的影响因素；ROC曲线分析彩超联合血清CCL3、P-selectin水平对髋部骨折患者发生LEDVT的诊断价值。结果 与对照组相比，LEDVT组血清CCL3、P-selectin水平均明显升高（P＜0.05）。与无LEDVT组相比，LEDVT组血清CCL3、P-selectin水平以及CFV、PFV、皮下组织增厚度均明显升高（P＜0.05）。Logistic回归分析显示，CFV、PFV、皮下组织增厚度、CCL3、P-selectin为髋部骨折患者发生LEDVT的独立影响因素（P＜0.05）。五者联合诊断的曲线下面积（AUC）（0.956）明显高于单一指标诊断，五者联合诊断的敏感度为81.25%，特异度为96.25%。结论 髋部骨折并发LEDVT患者血清CCL3、P-selectin水平均明显上调，且均为髋部骨折患者发生LEDVT的独立影响因素，彩超联合血清CCL3、P-selectin水平对髋部骨折患者发生LEDVT具有较高的诊断价值。
Abstract:Objective To investigate the value of color Doppler ultrasound combined with serum chemokine C-C motif ligand 3(CCL3) and P-selectin levels for the diagnosis of postoperative lower extremity deep vein thrombosis(LEDVT) in patients with hip fractures. Methods Eighty patients with hip fractures complicated with LEDVT admitted to Xi'an Gaoxin Hospital from September 2022 to September 2024 were regarded as the LEDVT group, 80 patients with hip fractures without LEDVT were regarded as the non-LEDVT group, and 80 healthy individuals who experienced physical examination were regarded as the control group. The levels of serum CCL3 and P-selectin in three groups were compared. Color Doppler flow imaging (CDFI) was applied to measure the inner diameters of the common femoral vein (CFV) and deep femoral vein (DFV), and the subcutaneous tissue thickening was calculated. Multivariate logistic regression was applied to analyze the influencing factors of LEDVT in patients with hip fractures. ROC curve was applied to analyze the diagnostic value of ultrasound combined with serum CCL3 and P-selectin levels for LEDVT in patients with hip fractures. Results Compared to the control group, both serum CCL3 and P-selectin levels were significantly higher in the LEDVT group (P＜0.05). Compared to the non-LEDVT group, the levels of serum CCL3, P-selectin, CFV, DFV, and subcutaneous tissue thickening were prominently higher in the LEDVT group (P＜0.05). CFV, PFV, subcutaneous tissue thickening, CCL3, and P-selectin were influencing factors for LEDVT in patients with hip fractures (P＜0.05). The combined diagnostic AUC (0.956) was significantly higher than that of any single indicator, with a sensitivity of 81.25% and specificity of 96.25%. Conclusion The levels of serum CCL3 and P-selectin are obviously upregulated in patients with hip fracture complicated with LEDVT, both of which are influencing factors for the occurrence of LEDVT in patients with hip fracture. Ultrasound combined with serum CCL3 and P-selectin levels has high diagnostic value for LEDVT in patients with hip fractures.
文章编号： 中图分类号：R587.1 R687.3 文献标志码：A
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附件
| 作者 | 单位 |
| 袁博 | 1.西安高新医院超声科，陕西 西安 710075 |
| 董洪娜 | 1.西安高新医院超声科，陕西 西安 710075 |
| 李亚丽 | 1.西安高新医院超声科，陕西 西安 710075 |
| 杨文斌 | 2.西安高新医院骨科，陕西 西安 710075 |
| 冉超 | 2.西安高新医院骨科，陕西 西安 710075 |
| Author Name | Affiliation |
| YUAN Bo, DONG Hongna, LI Yali, YANG Wenbin, RAN Chao | Department of Ultrasound, Xi'an Gaoxin Hospital, Xi'an, Shaanxi 710075, China |
引用文本：
袁博,董洪娜,李亚丽,等.彩超联合血清趋化因子配体3及P选择素对髋部骨折患者术后下肢深静脉血栓的诊断价值[J].中国临床研究,2025,38(2):225-229.
袁博,董洪娜,李亚丽,等.彩超联合血清趋化因子配体3及P选择素对髋部骨折患者术后下肢深静脉血栓的诊断价值[J].中国临床研究,2025,38(2):225-229.