血清D-二聚体、同型半胱氨酸及Wells评分对剖宫产术后并发下肢深静脉血栓的临床预判价值

发布时间：2018-04-25 16:44

本文选题：剖宫产 + 下肢深静脉血栓　；参考：《现代预防医学》2017年22期

【摘要】：目的探讨血清D-二聚体(D-D)、同型半胱氨酸(Hcy)及Wells评分检测对剖宫产术后并发下肢深静脉血栓(DVT)的临床预判价值。方法回顾性分析某院2010年1月-2017年1月行剖宫产术后并发DVT的37例产妇的临床资料,设为观察组。随机选取同期入院行剖宫产产妇未并发DVT者74例,设为对照组。比较2组产妇一般临床资料,选取具有统计学差异的临床指标构建受试者操作曲线(ROC曲线)。结果观察组中D-二聚体(D-D)、同型半胱氨酸(Hcy)、Wells评分、凝血酶原时间(PT)及活化部分凝血酶原时间(APTT)水平均明显高于对照组(P0.05)。ROC曲线分析显示,D-D、Hcy、Wells评分对应AUC分别为0.902、0.846和0.745,所对应最佳临界值分别为1.85μg/ml、15.73μmol/L和2.00分,敏感度分别为89.2%、75.7%和73.0%,特异度分别为84.8%、82.1%和65.4%,而APTT、Fib及PT其对应AUC分别为(0.683、0.675、0.649),AUC0.7,对DVT早期预判价值较低。结论 D-D、Hcy及Wells评分的异常升高对产妇剖宫产术后并发DVT有较大的早期预判价值。
[Abstract]:Objective to evaluate the clinical value of serum D-dimer (D-D), homocysteine (Hcy) and Wells score in the diagnosis of DVT of lower extremity deep vein thrombosis after cesarean section. Methods the clinical data of 37 cases with DVT after cesarean section in a hospital from January 2010 to January 2017 were analyzed retrospectively. 74 cases without DVT were randomly selected as control group. The general clinical data of the two groups were compared, and the ROC curve was constructed by selecting the clinical indexes with statistical difference. Results in the observation group, the scores of D- dimer D-D, homocysteine homocysteine homocysteine were measured. The levels of prothrombin time (PTT) and activated partial prothrombin time (APTTT) were significantly higher than those of the control group (P 0.05U 路ROC curve). The corresponding AUC of D-DX Hcyn Wells score was 0.902n0.846 and 0.745, respectively, and the optimal critical values were 1.85 渭 g / ml 15.73 渭 mol/L and 2.00 渭 g / ml, respectively. The sensitivity was 89.2% and 73.7%, and the specificity was 84.1% and 65.4%, respectively, while the corresponding AUC of APTTT Fib and PT was 0.6830.675U 0.649AUC 0.7, which was lower in early prediction of DVT. Conclusion the abnormal increase of D-DG Hcy and Wells score is of great value in early prediction of DVT after cesarean section.
【作者单位】：海南省农垦三亚医院妇产科;
【分类号】：R719.8

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