补体C3和C4与老年髋部骨折术前深静脉血栓形成的相关性及其诊断价值
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北京积水潭医院培育计划( ZR-202111)


Correlation and diagnostic value of complement C3 and C4 with preoperative deep vein thrombosis in elderly patients with hip fracture
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    摘要:

    摘要:目的探讨补体 C3和C4与老年髖部骨折术前深静脉血栓形成(DVT)的相关性及其诊断价值。方法连续纳入 北京积水潭医院老年髋部骨折患者并观察,行术前血管造影或彩超以筛查DVT并确诊DVT的患者共50例纳入DVT组,在未确诊DVT患者中以1:1的比例纳入与DVT组性别、年龄匹配的患者作为对照组(非DVT组)。用免疫比浊法测定血清C3和C4浓度并进行统计学分析;绘制ROC曲线以评估各指标对DVT的诊断价值。结果DVT 组、非DVT组血清C3浓度分别为( 1.162+0.223)g/L.(0.869+0.206)g/L;C4浓度分别为(0.307+0.070) g/L.(0.257+0.079)g/L, DVT组C3.C4水平均高于非DVT组(P均<0.05)。ROC曲线表明,C3的ROC曲线下面积(AUCRO)为0.839,当cut-off 值为0.893 g/L时,敏感性为70.0%(95%C1:56.3%~ 80.%) ,特异性为94.0% (95%CI:83.8% ~98.4%);C4的AUCROC为0.683,当cut-off值为0.267g/L时,敏感性为58.0%( 95%Cl:44.2%~ 70.6%) ,特异性为76.0% (95%CI:62.6% ~85.7%)。纳入C3、Fib .D-二聚体以及Caprini 评分构建回归模型计算的组合因子AUCHOC为0.943。结论补体 C3和C4与老年髋部骨折术前DVT相关联并具有诊断价值。

    Abstract:

    Abstract: Objective To investigate the correlation of complement C3 and C4 with preoperative deep vein thrombosis (DVT) and its diagnostic value in elderly patients with hip fracture. Methods A total of fty elderly patients with hip fracture who were diagnosed as DVT were included in study group. Preoperative angiography or ultrasound was conducted to screen DVT and the patients were continu ously observed. The patients undiagnosed DVT who were matching with DVT group in sex and age were included as the control group ( non-DVT group) witha ratio of 1:1. The concentration of serum C3 and C4 were determined by using immunonephelometry assay and analyzed statistically. The receiver operating characteristic ( ROC) curve was drawn to evaluate the diagnostic value of each parameter.Results The concentrations of serum C3 in DVT group and non-DVT group were ( 1.162+0.223) g/L and (0.869+0.206) g/L, and C4 concentations were (0.307+0.070) g/L and ( 0.257+0.079) g/L, respectively. The levels of C3 and C4 in DVT group were signif- icantly higher than those in non-DVT group ( all P values <0.05). ROC analysis showed that the area under curve ( AUCROC ) ofC3 was 0.839, the sensitivity was 70.0% (95%CI:56.3% to 80.9%) and the specificity was 94.0%( 95%CI:83.8% to 98.4%) when the cut-off value was 0.893 g/L. The AUCROC of C4 was 0.683, the sensitivity was 58.0% (95%CI:44.2% to 70.6%) and the specifieity was76.0% (95%C1:62.6% to 85.7% ) when the cut-off value was 0.267 g/L. The combination factor created by the regression model including C3 , fibrinogen, D-dimer and Caprini score exhibited an AUCROC as 0.943. Conclusion The levels of complement C3 and C4 showed correlation with preoperative DVT in elderly patients with hip fracture ,which should be of diagnostic value.

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苏玉,曹翔宇,臧新伟,章文洁,任文华,李春艳,董辉苒,梁翠莹,吴俊.补体C3和C4与老年髋部骨折术前深静脉血栓形成的相关性及其诊断价值[J].临床检验杂志,2023,41(01):22-26

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  • 收稿日期:2022-12-11
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  • 在线发布日期: 2023-05-22
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