【摘要】 目的 探讨D-二聚体（D-D）/血小板（PLT）比值（DPR）对股骨粗隆间骨折内固定术后新发下肢深静脉血栓（DVT）的预测价值。方法 选取2023年1月至2025年1月在延安大学附属医院行内固定术的196例股骨粗隆间骨折患者作为研究对象，根据术后有无新发下肢DVT将其分为DVT组（39例）和无DVT组（157例）。采用免疫比浊法检测D-D水平，采用血液细胞分析仪检测PLT水平，并计算DPR。采用受试者工作特征（ROC）曲线评估DPR对股骨粗隆间骨折内固定术后新发下肢DVT的预测价值；采用多因素Logistic逐步回归分析探讨股骨粗隆间骨折内固定术后新发下肢DVT的影响因素。结果 DVT组D-D、DPR高于无DVT组，PLT低于无DVT组（均P<0.05）。ROC曲线分析显示，DPR预测股骨粗隆间骨折内固定术后新发下肢DVT的曲线下面积（AUC）为0.931，高于D-D(AUC=0.729)、PLT(AUC=0.805)单独预测（Z=8.946、10.153,P<0.001）。DVT组合并慢性病种类≥3种比例、C反应蛋白、纤维蛋白原高于无DVT组，受伤至入院时间、术后首次下床活动时间长于无DVT组（均P<0.05）。多因素分析显示，合并慢性病种类（OR=2.519,95%CI:1.375~4.617）、术后首次下床活动时间（OR=2.217,95%CI:1.355~3.625）、CRP(OR=2.337,95%CI:1.366~3.999)、DPR(OR=2.980,95%CI:1.722~5.159)是股骨粗隆间骨折内固定术后新发下肢DVT的独立影响因素（P<0.05）。结论 DPR升高与股骨粗隆间骨折内固定术后新发下肢DVT密切相关，且DPR对股骨粗隆间骨折内固定术后新发下肢DVT具有较好的预测价值。更多还原

【Abstract】 Objective To assess the predictive value of the D-dimer(D-D)/platelet(PLT) ratio(DPR) for postoperative lower extremity deep vein thrombosis(DVT) following internal fixation of femoral intertrochanteric fractures. Methods A total of 196 patients with intertrochanteric fractures of the femur who underwent internal fixation at the Affiliated Hospital of Yan’an University from January 2023 to January 2025 were selected as the research subjects. They were divided into the DVT group(n=39) and the non-DVT group(n=157) based on the presence or absence of new-onset lower extremity DVT after surgery. Serum D-D(immunoturbidimetry) and PLT(hematology analyzer) levels were measured, with DPR calculated.Receiver operating characteristic(ROC) curve analysis evaluated DPR’s predictive performance, while multivariate logistic regression identified independent risk factors. Results The DVT group showed significantly higher D-D and DPR levels but lower PLT compared to the non-DVT group(P<0.05). ROC analysis demonstrated DPR’s superior predictive capacity [area under the curve(AUC)=0.931] over D-D(AUC=0.729) and PLT(AUC=0.805)(Z=8.946, 10.153, P<0.001). DVT patients had higher proportions of ≥ 3chronic diseases, elevated CRP/FIB, and prolonged intervals from injury-to-admission and surgery-to-ambulation(P<0.05).Multivariate analysis identified chronic diseases burden(OR=2.519, 95%CI: 1.375-4.617), delayed ambulation(OR=2.217,95%CI: 1.355-3.625), CRP(OR=2.337, 95%CI: 1.366-3.999), and DPR(OR=2.980, 95%CI: 1.722-5.159) as independent predictors(P<0.05). Conclusion Elevated DPR strongly correlates with postoperative DVT and demonstrates superior predictive performance, providing a reliable biomarker for thrombosis risk assessment.更多还原