D-二聚体和纤维蛋白原降解产物检测在骨折患者深静脉血栓中的诊断价值分析

目的分析骨折病人血浆中D-二聚体(D-D)和纤维蛋白原降解产物(FDP)水平变化，了解其二者联合检测在骨折诊断下肢深静脉血栓(DVT)方面的价值。 方法回顾性分析了128例骨折病人血浆中D-D和FDP水平变化，其中骨折合并DVT组75例，骨折未合并DVT组53例。分别对两组患者开展下肢静脉超声检查、FDP与D-D检测，评估其临床诊断价值。对两组患者术后1 d、7 d、14 d、21 d的D-D和FDP的水平进行动态监测，以观察二者对骨折预后的影响。 结果两组患者的D-D、FDP水平均有统计学差异(t=8.54，P=0.004；t=5.69，P=0.024)。骨折并DVT组患者D-D和FDP于骨折术后1 d内急剧升高，与骨折无DVT组比较均有显著性差异(t=6.89，P=0.000；t=5.19 ，P=0.000)，骨折并DVT组患者D-D和FDP于术后21 d和14 d降至正常水平。D-D和FDP联合检测对骨折DVT患者的敏感性、特异性均高于二者单独检测。 结论D-D和FDP联合检测可以提高二者单独检测对诊断DVT的敏感度和特异性，具有较高的诊断价值，二者动态监测还可作为骨折治疗及预后的监测指标。

Analysis of the diagnostic value of D-dimer and FDP in fracture patients with deep venous thrombosis

ObjectiveTo analyze the changes of plasma D-Dimer (D-D) and fibrinogen degradation product (FDP) levels in fracture patients, and to understand the value of combined detection of D-D and FDP in the diagnosis of lower extremity deep venous thrombosis (DVT). MethodsThe changes of plasma D-D and FDP levels in 128 patients with fracture were retrospectively analyzed, including 75 fracture patients combined with DVT group and 53 fracture patients without DVT group. The lower extremity venous ultrasound, FDP and D-D detection were carried out in the two groups respectively to evaluate the clinical diagnostic value. The levels of D-D and FDP on 1 d, 7 d, 14 d and 21 d after operation in both groups were dynamically monitored to observe the effects on fracture prognosis. ResultsThere were statistically significant differences in D-D and FDP between the two groups (t=8.54, P=0.004; t=5.69, P=0.024).The levels of D-D and FDP increased sharply within 1 d after operation in fracture patients with complicated with DVT, which was significantly different from that of patients without DVT(t=6.89, P=0.000; t=5.19, P=0.000).The levels of D-D and FDP decreased to normal level at 21 d and 14 d in DVT group. The sensitivity and specificity of combined detection of D-D and FDP were higher than those of single detection. ConclusionCombined detection of D-D and FDP can improve the sensitivity and specificity in the diagnosis of DVT and have high diagnostic value. The dynamic monitoring of D-D and FDP can also be used as the monitoring index of fracture treatment and prognosis.