【摘要】 目的:通过比较骨创伤患者与健康人群的临床资料,分析骨创伤后深静脉血栓形成(DVT)的相关危险因素。方法:选择住院骨创伤患者但未发生深静脉血栓患者126例(骨创伤组)、DVT患者30例(DVT组)以及进行体检无创伤、心血管疾病和血栓性疾病的健康者60例(对照组)作为研究对象。D-二聚体(D-D)含量检测采用散射比浊法,纤维蛋白原(FIB)测定采用PT导出法,抗心磷脂抗体(ACA,IgA,IgM,IgG)检测采用酶联免疫法,C反应蛋白(CRP)含量检测采用速率散射比浊法。结果:骨创伤组和DVT组患者纤维蛋白原、D-二聚体均明显高于对照组,且差异均具有统计学意义(P<0.05);DVT组与骨创伤组相比,此三者平均含量均升高,其中C反应蛋白含量具有统计学差异(P<0.05);骨创伤组ACA阳性率与对照组ACA阳性率之间无统计学差异(P>0.05);而DVT组ACA阳性率与对照组之间存在着统计学差异(P<0.05);DVT组患者平均年龄明显高于骨创伤组,两者差异具有统计学意义(P<0.05);DVT组患者多部位骨折发生率明显高于骨创伤组,两者差异具有统计学意义(P<0.05);DVT组患者溶栓治疗前后纤维蛋白原、D-二聚体均明显降低,且差异具有统计学意义(P<0.05)。结论:纤维蛋白原、D-二聚体、C反应蛋白升高和抗心磷脂抗体阳性是深静脉血栓患者的危险因素。年龄越大以及骨折情况越严重骨创伤患者发生深静脉血栓危险性越大,溶栓治疗对深静脉血栓患者的治疗效果显著。更多还原

【Abstract】 Objective: To analyse the risk factors of the deep vein thrombosis after bone trauma through comparing the clinical data of bone trauma patients and that of healthy people. Methods: 126 bone trauma patients without deep vein thrombosis in hospital(traumatic fracture group), 30 DVT patients(DVT group) and 60 healthy patients(control group) were chosen as subjects. D-dimer was detected by coagulation analyzer, fibrinogen(FIB) was determined by PT derived method, Anti-cardiolipin antibody(ACA) was determined by ELISA method and C-reactive protein(CRP) by rate nephelometry. Results: Levels of D-dimer, FIB and CRP in traumatic fracture group and DVT group significantly increased compared with that in the control group(P<0.05); while compared with traumatic fracture group, the D-dimer, FIB and CRP were improved in DVT group, and the CRP significantly increased(P<0.05); ACA positive rate in DVT group presented significant increase compared with that in control group(P<0.05); ACA positive rate in traumatic fracture group presented no significant difference compared with that in control group(P>0.05).The average age in DVT group significantly increased in traumatic fracture group; The incidence of multiple fractures in DVT group was higher than in traumatic fracture group;Before and after thrombolytic therapy, fibrinogen(FIB) and D-dimer significantly decreased in DVT group(P<0.05). Conclusion: FIB,D-dimer and CRP and positive ACA are risk factors for DVT after bone trauma. The risk of DVT increases with the age and the severity of the fracture. Thrombolytic treatment in patients with deep venous thrombosis is effective.更多还原