D-D、FIB及PAI-1在创伤性脊柱骨折表达及术后静脉血栓的预测

目的探讨D-二聚体(D-D)、纤维蛋白原(FIB)及纤溶酶元激活物抑制剂(PAI-1)在创伤性脊柱骨折中的表达及对术后静脉血栓事件的预测价值。方法选取2017年3月至2020年3月本院接收的100例创伤性脊柱骨折患者设为研究组,选取同期并将同期检查的78例健康人群设为对照组。根据是否发生静脉血栓事件将发生静脉血栓的患者设为A组(n=56),未发生静脉血栓的患者设为B组(n=44)。收集所有研究对象的一般资料,比较各组D-D、FIB及PAI-1差异;统计创伤性脊柱骨折术后发生静脉血栓事件情况;采用ROC曲线分析D-D、FIB及PAI-1及三者联合对创伤性脊柱骨折术后静脉血栓事件的预测价值,采用Logistic回归分析影响创伤性脊柱骨折术后出现静脉血栓事件的危险因素。结果研究组患者D-D、FIB及PAI-1水平明显高于对照组,差异具有统计学意义(P<0.05);100例患者中有56例出现术后静脉血栓事件,发生率为56.00%;A组患者D-D、FIB及PAI-1水平明显高于B组,差异具有统计学意义(P<0.05);高血压、基础疾病、手术时间、D-D、FIB、PAI-1为影响影响创伤性脊柱骨折术后静脉血栓事件发生的单因素(P<0.05);有高血压病史、基础疾病≥2种、D-D、FIB及PAI-1异常升高为影响创伤性脊柱骨折术后静脉血栓事件发生的独立危险因素(P<0.05)。D-D曲线下面积为0.693,FIB曲线下面积为0.828,PAI-I曲线下面积为0.901,三者联合曲线下面积为0.947,在D-D、FIB、PAI-1指标中,以联合检测下面积值最大。结论D-D、FIB及PAI-1水平检测创伤性脊柱骨折中术后出现静脉血栓事件具有重要价值,临床可根据其指标进行相关监测。

Expression of D-D,FIB and PAI-1 in traumatic spinal fractures and its predictive value for postoperative venous thrombosis

Objective To explore the expression of D-dimer(D-D),fibrinogen(FIB)and plasmin activator inhibitor(PAI-1)in traumatic spinal fractures and their predictive value for postoperative venous thrombosis.Methods The 100 patients with traumatic spine fractures treated in our hospital from March 2017 to March 2020 were selected as the study group.78 healthy people examined during the same period were set as the control group.According to whether a venous thrombosis event occurred,patients with venous thrombosis were set as group A(n=56),and patients without venous thrombosis were set as group B(n=44).The general data of all patients were collected,and the differences between the two groups in D-D,FIB and PAI-1 were compared.The occurrence of venous thrombosis after traumatic spine fracture was counted.The ROC curve was used to analyze the predictive value of D-D,FIB and PAI-1 and the combination of them for venous thrombotic events after traumatic spine fractures,and Logistic regression was used to analyze the risk factors of venous thrombosis after traumatic spinal fracture.Results The levels of D-D,FIB and PAI-1 in the study group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).In the 100 patients,56 had postoperative venous thrombosis events.The incidence was 56.00%.The levels of D-D,FIB,and PAI-1 in group A were significantly higher than those in group B,and the difference was statistically significant(P<0.05).Hypertension,underlying diseases,operation time,D-D,FIB,and PAI-1 are single factors that affect the occurrence of venous thrombosis after traumatic spinal fracture surgery(P<0.05).The history of hypertension,underlying diseases≥2 types,abnormal increasing of D-D,FIB and PAI-1 were independent risk factors affecting the occurrence of venous thrombosis after traumatic spinal fracture(P<0.05).The area under the D-D curve was 0.693,the area under the FIB curve was 0.828,the area under the PAI-I curve was 0.901,and the area under the combined curve was 0.947.Among the D-D,FIB,and PAI-1 indicators,the area under the combined curve was the largest.Conclusion D-D,FIB and PAI-1 levels are of great value in detecting venous thrombosis in patients with traumatic spine fractures,and clinical monitoring can be carried out based on their indicators.