血浆P-选择素水平对髋关节置换术后下肢深静脉血栓形成的诊断价值

目的探讨P-选择素诊断髋关节置换术后下肢深静脉血栓（DVT）的诊断价值及其适合的诊断临界值。方法选择行单髋关节置换术患者122例,根据术后彩超检查结果将其分为血栓组和非血栓组,另选50例健康体检者作为对照组。采用ELISA法测定三组P-选择素水平;以不同检测值为临界点,以每个临界点对应的敏感度为纵坐标,1-特异度为横坐标作图得到ROC曲线,计算ROC曲线下的面积（AUC）、不同临界点时敏感度、特异度和阳性似然比。结果血栓组术后P-选择素水平高于非血栓组,P〈0.01;选取曲线图中最左上方的点对应的值为42 ng/ml,AUC为0.716。结论P-选择素对髋关节置换术围手术期DVT的形成具有重要的预警作用;其诊断髋关节置换术后DVT的最佳诊断临界值为42 ng/ml。

Diagnostic value of P-selectin levels in plasma on the lower deep vein thrombosis after hip replacement

Objective To investigate the diagnostic value of P-selectin levels in plasma on the lower deep vein thrombosis after hip replacement and its diagnosis threshold.Methods One hundreds and twenty-two patients undergoing hip replacement were selected,and were divided into DVT group and non-DVT group according to color doppler examination,then 50 healthy people were selected as control group.The content of P-selectin in plasma of the three groups were detected by ELISA;the ROC curve was drawn with the sensitivity for the vertical and 1-specificity for the horizontal in each different point,the area under the curve（AUC）,the sensitivity,specificity,and positive likelihood ratio in different critical points were calculated.Results P-selectin levels of the DVT group were higher than that in the non-DVT group after surgery,P0.01.The top-left point in the curve 42 ng/ml was selected as the best diagnostic threshold,AUC was 0.716.Conclusion P-selectin play an important early warning role in DVT during perioperative period of hip replacement.The best threshold for the diagnosis of the DVT is 42 ng/ml.