Plasma D-dimer and fibrinogen in patients with different types of orthopedic diseases
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摘要:
目的 分析不同类型骨科疾患患者血浆中D-二聚体与纤维蛋白原的水平，探讨不同类型骨科疾患患者并发血栓性疾病倾向性。 方法 对患有不同类型骨科疾患的患者血浆D-二聚体、纤维蛋白原（FIB）及其他凝血指标凝血酶原时间、部分活化凝血活酶时间、凝血酶时间和白细胞、血小板的检测结果进行统计分析。 结果 所有病例组D-二聚体升高程度和异常率最高，其次为FIB，其值在各组中从高到低依次为股骨骨折组、胸椎腰椎骨折组、其他骨折组、椎间盘突出组、关节病组，各病例组与健康对照组比较差异有统计学意义（P<0.05）；D-二聚体异常率股骨骨折组为100%，胸腰椎骨折组94%，其他骨折组88.23%，关节病组64.56%，椎间盘突出组62.63%。 结论 除了骨折和手术患者D-二聚体升高明显之外，其他各类骨科疾患患者血浆D-二聚体水平和FIB也都普遍升高，提示不同骨科疾患患者都有并发血栓性疾病的倾向，密切观察D-二聚体和FIB水平，警惕深静脉血栓的发生。 Abstract:Objective To analyze the levels of D-dimer and fibrinogen in plasma of patients with different types of orthopedic diseases, and to explore the tendency of patients with different types of orthopedic disorders complicated with thrombotic diseases. Methods The measured results of D-dimer, FIB, PT, APTT, TT, WBC and PLT were compared in patients with different types of orthopedic diseases. Results The measured results and rate of abnormality of D-dimer in all groups were the highest.The second was FIB.From higher to lower in turn for group of femoral fracture, thoracic vertebr and lumbar vertebral fracture, other fracture, cervical vertebra and lumbar disc herniation, the joint disease.Compared with healthy control group, the measured results and rate of abnormality of D-dimer and FIB were significant different. The rate of abnormality of D-dimer in the group of femoral fracture was 100%, thoracic vertebr and lumbar vertebral fracture 94%, other fracture 88.23%, the joint disease 64.56%, cervical vertebra and lumbar disc herniation 62.63%. Conclusion In addition to fracture and surgery patients with significant increase in D-dimer, the other types of orthopedic disorders in patients with plasma D-dimer levels and FIB are generally increased.It means that patients with different orthopedic disorders have thrombotic disease tendencies, close observation of D-dimer and FIB levels, alert to the occurrence of deep vein thrombosis. -
Key words:
- orthopedic disorders /
- D-dimer /
- fibrinogen /
- deep vein thrombosis
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表 1 各组各指标检测结果的比较（
$\, \overline{{x}}{{±}}{{s}}$ ）组别 n D-DI FIB PT APTT TT WBC PLT 股骨骨折组 71 6.44±6.20* 4.33±0.93* 13.35±1.03* 43.56±38.76 16.53±1.93 9.52±3.25* 279.21±96.23* 胸、腰椎骨折组 50 3.24±2.79* 4.25±1.24* 13.60±0.65* 34.91±3.74 17.33±1.67 7.82±2.73* 244.60±73.98 其他骨折组 68 3.06±4.08* 4.23±1.02* 12.91±1.11 36.43±5.07 16.53±1.16 8.16±1.93* 276.58±73.2* 关节病组 79 1.25±1.54* 4.11±1.21* 12.78±0.81 36.19±4.75 16.99±1.43 7.54±2.35* 291.61±76.46* 椎间盘突出组 93 1.54±2.67* 3.89±1.12* 13.12±0.94* 37.06±4.99 16.91±1.28 7.15±1.77* 239.13±61.07 对照组 46 0.31±0.09 3.16±0.44 12.57±0.81 35.93±2.96 16.74±1.25 6.11±1.50 222.80±42.79 *P<0.05. 
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表 2 各组各指标阳性率的比较（%）
组别 D-DI FIB PT APTT TT WBC PLT 股骨骨折组 100 66.67 8.33 4.17 0 45.83 12.5 胸、腰椎骨折组 94 45 0 0 5 20 10 其他骨折组 88.23* 61.54* 3.85 11.54 0 23.08 11.5 关节病组 64.56 36.11 2.78 5.56 2.78 22.22 22.2 椎间盘突出组 62.3 44.26 3.28 8.2 0 6.56 3.28 *P<0.05vs关节病组.
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