摘要
目的分析多普勒超声参数联合血清可溶性CD40配体(sCD40L)诊断产褥期下肢深静脉血栓(DVT)的价值。方法选择2019年3月—2021年10月胜利油田中心医院妇产科收治产褥期DVT产妇115例(DVT组),另选择同期于医院分娩未发生DVT的产妇120例为对照组。根据Caprini血栓风险评估表将DVT患者分为低危亚组(0~1分)5例、中危亚组(2分)29例、高危亚组(3~4分)32例和极高危亚组(≥5分)49例。采用下肢多普勒超声获得受试者收缩期峰值流速(PSV)、阻力指数(RI)、搏动指数(PI),并检测血清sCD40L。Spearman秩相关分析PSV、RI、PI、血清sCD40L与Caprini血栓风险分级的相关性,ROC曲线分析PSV、RI、PI、血清sCD40L诊断产褥期DVT的价值。结果DVT组PSV低于对照组(t/P=9.739/<0.001),RI、PI及血清sCD40L水平均显著高于对照组(t/P=5.352/<0.001、3.494/0.001、45.702/<0.001)。RI、PI、血清sCD40L比较,极高危亚组>高危亚组>中危亚组>低危亚组(F/P=98.265/<0.001、65.341/<0.001、59.468/<0.001),PSV比较,极高危亚组<高危亚组<中危亚组<低危亚组(F/P=135.262/<0.001)。DVT组PSV与Caprini血栓风险分级呈负相关(r_(s)/P=-0.662/<0.001),RI、PI、血清sCD40L与Caprini血栓风险分级呈正相关(r_(s)=0.520、0.415、0.738,P<0.001)。PSV、RI、PI、血清sCD40L及4项联合诊断产褥期DVT的曲线下面积为0.707、0.641、0.603、0.699、0.899,4项联合高于单独诊断者(Z=5.363、6.868、7.866、5.612,P均<0.001)。结论产褥期DVT患者PSV降低,RI、PI增加,血清sCD40L水平增高,且与DVT风险分级增加有关,PSV、RI、PI联合血清sCD40L是诊断产褥期DVT的可靠指标。
Objective To analyze the value of Doppler ultrasound parameters combined with serum soluble CD40 ligand(sCD40L)in the diagnosis of puerperium deep vein thrombosis(DVT).Methods Selected from March 2019 to October 2021 in the Department of Obstetrics and Gynecology of Shengli Oilfield Central Hospital to treat puerperium DVT women(DVT group).Another 120 puerperae who did not develop DVT in hospital during the same period were selected as the control group.According to the Caprini Thrombosis Risk Assessment Scale,DVT patients were divided into low-risk subgroup(0-1 points)5 cases,intermediate-risk subgroup(2 points)29 cases,high-risk subgroup(3-4 points)32 cases and very high-risk subgroups Group(≥5 points)49 cases.The subjects'peak systolic flow velocity(PSV),resistance index(RI),pulsatility index(PI)were obtained by lower extremity Doppler ultrasound,and serum sCD40L was detected.Spearman rank correlation analysis of PSV,RI,PI,serum sCD40L and Caprini thrombosis risk grading correlation,ROC curve analysis of the value of PSV,RI,PI,serum sCD40L in the diagnosis of puerperium DVT.Results The PSV in the DVT group was lower than that in the control group(t/P=9.739/<0.001),and the levels of RI,PI and serum sCD40L were significantly higher than those in the control group(t/P=5.352/<0.001,3.494/0.001,45.702/<0.001).Comparison of RI,PI and serum sCD40L,very high risk subgroup>high risk subgroup>intermediate risk subgroup>low risk subgroup(F/P=98.265/<0.001,65.341/<0.001,59.468/<0.001),PSV comparison,Very high risk subgroup<high risk subgroup<intermediate risk subgroup<low risk subgroup(F/P=135.262/<0.001).In DVT group,PSV was negatively correlated with Caprini thrombosis risk classification(r_(s)/P=-0.662/<0.001),and RI,PI and serum sCD40L were positively correlated with Caprini thrombosis risk classification(r_(s)=0.520,0.415,0.738,P<0.001).The area under the curve of PSV,RI,PI,serum sCD40L and 4 items combined to diagnose puerperium DVT were 0.707,0.641,0.603,0.699,0.899,and the 4 items combined were higher than those diagnosed alone(Z=5.363,6.868,7.866,5.612,P All<0.001).Conclusion In puerperal DVT patients,PSV decreased,RI and PI increased,and serum sCD40L level increased,which was associated with increased DVT risk classification.
作者
王晓萌
黄诗玫
周炜
刘燕岭
Wang Xiaomeng;Huang Shimei;Zhou Wei;Liu Yanling(Department of Obstetrics and Gynecology Ultrasound,Shengli Oilfield Central Hospital,Shandong Province,Dongying 257000,China;不详)
出处
《疑难病杂志》
CAS
2022年第5期502-506,共5页
Chinese Journal of Difficult and Complicated Cases
基金
山东省科学技术厅项目(2019GX101016)。
关键词
下肢深静脉血栓
产褥期
多普勒超声
可溶性CD40配体
诊断
Deep venous thrombosis of lower extremities
Puerperium
Doppler ultrasound
Soluble CD40 ligand
Diagnosis
