摘要
目的探讨血小板平均体积(MPV)/淋巴细胞(LYM)比值(MPVLR)对下肢创伤骨折患者术后发生深静脉血栓(DVT)的预测价值,以期为采取针对性措施预防下肢创伤骨折患者术后发生DVT提供参考。方法选取2019年1月—2024年7月汉中市中心医院收治的下肢创伤骨折患者132例,检测所有患者术后MPV和LYM水平并计算MPVLR。根据患者术后是否发生DVT分为DVT组(n=38)和非DVT组(n=94)。分析MPV、LYM及MPVLR对下肢创伤骨折患者术后发生DVT的预测价值,并探讨下肢创伤骨折患者术后发生DVT的影响因素。结果DVT组患者MPV和MPVLR水平高于非DVT组,LYM水平低于非DVT组,差异均有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,MPV、LYM及MPVLR预测下肢创伤骨折患者术后发生DVT的曲线下面积(AUC)分别为0.739(95%CI:0.694~0.789)、0.802(95%CI:0.752~0.847),0.913(95%CI:0.868~0.963);MPVLR预测下肢创伤骨折患者术后DVT最佳截断值为7.82。2组患者年龄、性别构成、身体质量指数(BMI)、骨折类型、创伤部位、手术方式、饮酒史比例比较,差异无统计学意义(P>0.05);DVT组患者手术时间和术后卧床时间长于非DVT组,吸烟史、高血压史和糖尿病史比例高于非DVT组,差异均有统计学意义(P<0.05)。二分类logistic逐步回归分析结果显示,手术时间增加(OR=2.312,95%CI:1.315~4.065)、术后卧床时间增加(OR=2.686,95%CI:1.345~5.365)、MPV≥10.65fL(OR=2.680,95%CI:1.440~4.989)、LYM≤1.60×10^(9)/L(OR=2.898,95%CI:1.629~5.156)、MPVLR≥7.82(OR=4.208,95%CI:2.174~8.146)是下肢创伤骨折患者术后发生DVT的独立危险因素(P<0.05)。结论MPVLR在预测下肢创伤骨折患者DVT风险中具有重要价值,能够准确反映术后血栓形成的可能性,从而辅助临床早期干预决策。
Objective To investigate the predictive value of mean platelet volume-to-lymphocyte ratio(MPVLR)for postoperative deep vein thrombosis(DVT)in patients with lower limb traumatic fractures,providing evidence for targeted preventive interventions.Methods A total of 132 patients with lower limb traumatic fractures admitted to Hanzhong Central Hospital from January 2019 to July 2024 were enrolled.Postoperative mean platelet volume(MPV)and lymphocyte(LYM)levels were measured,and MPVLR was calculated.Patients were allocated to DVT(n=38)and non-DVT(n=94)groups based on postoperative DVT occurrence.The predictive value of MPV,LYM,and MPVLR for DVT was analyzed,and risk factors for postoperative DVT were explored.Results The DVT group exhibited significantly higher MPV and MPVLR but lower LYM compared to the non-DVT group(P<0.05).Receiver operating characteristic(ROC)analysis showed that MPV,LYM,and MPVLR predicted postoperative DVT with AUCs of 0.739(95%CI:0.694-0.789),0.802(95%CI:0.752-0.847),and 0.913(95%CI:0.868-0.963),respectively,with an optimal MPVLR cutoff of 7.82.No significant differences existed in age,sex,body mass index(BMI),fracture type,injury site,surgical approach,or alcohol history(P>0.05).However,the DVT group had longer operative duration,prolonged postoperative bed rest,and higher rates of smoking history,hypertension,and diabetes(P<0.05).Binary logistic regression identified prolonged operative time(OR=2.312,95%CI:1.315-4.065),extended bed rest(OR=2.686,95%CI:1.345-5.365),MPV≥10.65 fL(OR=2.680,95%CI:1.440-4.989),LYM≤1.60×10^(9)/L(OR=2.898,95%CI:1.629-5.156),and MPVLR≥7.82(OR=4.208,95%CI:2.174-8.146)as independent risk factors(P<0.05).Conclusion MPVLR demonstrates significant value in predicting DVT risk after lower limb fracture surgery,providing a reliable biomarker for early clinical intervention.
作者
张利鹏
屈福锋
翟英杰
赵旭东
周新立
王东
张磊
李雪
赵小龙
Zhang Lipeng;Qu Fufeng;Zhai Yingjie;Zhao Xudong;Zhou Xinli;Wang Dong;Zhang Lei;Li Xue;Zhao Xiaolong(Department of Orthopedic Trauma,Hanzhong Central Hospital,Hanzhong Shaanxi 723000,China;Department of Joint Surgery,Hanzhong Central Hospital,Hanzhong Shaanxi 723000,China;Department of Orthopedics,Affiliated Hospital of Hanzhong Vocational and Technical College,Hanzhong Shaanxi 723000,China)
出处
《保健医学研究与实践》
2025年第3期68-74,共7页
Health Medicine Research and Practice
基金
陕西省卫生健康科研创新能力提升计划立项项目(2024PT-16)。
