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目的:探讨血清同型半胱氨酸(Hcy)以及血浆D-二聚体(D-D)水平在老年患者骨折后并发深静脉血栓(DVT)中的临床应用价值。方法:选取华中科技大学同济医学院附属协和医院骨科收治的骨折患者104例,根据骨折后是否发生下肢DVT分为非DVT组31例和DVT组73例,选取同期健康体检者22例为对照组,采用酶循环法检测血清Hcy水平、胶乳增强免疫透射比浊法检测血浆D-D,对各组Hcy和D-D水平进行比较,并统计Hcy和D-D在各组中的阳性率。结果:非DVT组和DVT组的Hcy和D-D均较对照组增高(P<0.05),DVT组的Hcy和D-D较非DVT组增高,差异有统计学意义(P<0.05);DVT组的Hcy阳性率高于对照组和非DVT组(P<0.05),非DVT组的Hcy阳性率较对照组相比差异无统计学意义(P>0.05),DVT组和非DVT组的D-D阳性率高于对照组(P<0.01),DVT组的D-D同非DVT组相比差异无统计学意义(P>0.05)。结论:血清Hcy和血浆D-D在骨折特别是合并DVT患者中较健康人群高,对于评价骨折后DVT形成具有一定的临床意义。
Objective: To investigate the clinical value of serum homocysteine (Hcy) and plasma D-dimer (D-D) levels in the elderly patients with deep vein thrombosis (DVT) after fracture. Methods: A total of 104 patients with fracture treated by Department of Orthopedics, Union Hospital of Tongji Medical College of Huazhong University of Science and Technology were enrolled in this study. According to whether DVT occurred in 31 cases of non-DVT group and 73 cases of DVT group after fracture, 22 healthy subjects were selected as control group , The level of serum Hcy was measured by enzyme-linked immunosorbent assay (ELISA), the level of serum homocysteine (DD) was measured by latex enhanced immunoturbidimetric assay. The positive rates of Hcy and DD in each group were calculated. Results: The levels of Hcy and DD in non-DVT group and DVT group were significantly higher than those in control group (P <0.05), while those in DVT group were significantly higher than those in non-DVT group (P <0.05) The positive rate of Hcy in non-DVT group was higher than that in control group and non-DVT group (P <0.05), while the positive rate of Hcy in non-DVT group was not significantly different from that of control group (P> 0.05) In control group (P <0.01), there was no significant difference in DD between DVT group and non-DVT group (P> 0.05). Conclusion: Serum Hcy and plasma D-D levels are higher in patients with fractures, especially patients with DVT, than those in healthy people. It is of clinical significance for the evaluation of DVT after fracture.