血尿酸与髋部骨折患者伴深静脉血栓及肺栓塞形成的相关性分析

摘要

Objective To explore the correlation between serum uric acid (UA)level and the formation of deep venous thrombosis (DVT).Method The experimental group consisted of 295 hip fracture patients who were divided into three groups ac-cording to their condition at discharge.Of 295 patients,42 cases of emboli of pulmonary embolism caused by DVT;121 cases only showed DVT;132 cases of patients who only had hip fractures constituted the control group.All three groups had basic low molec-ular weight heparin anticoagulation treatment,while the PTE and DVT groups further received low molecular weight heparin anti-coagulation treatment once upon pathogenesis.The weekly UA levels were observed in both experimental groups from admittance, upon pathogenesis and during the three weeks of treatment.At the same time,the control group′s UA levels were taken every week after admittance.Results The three groups′UA levels at admittance showed no statistically significant difference (P >0.05).At pathogenesis,the PTA group′s UA levels were significantly higher than thos of the DVT and control groups,the difference was sta-tistically significant(P <0.05),while the DVT group′s level was higher than the control group′s,the difference was statistically significant (P <0.05).While their condition stabilized,the PTE and DVT groups′UA levels gradually dropped to stable levels, but the difference to the control group was not statistically significant (P >0.05).At admittance,however,the control group′s UA level was elevated;although after three weeks of observation,their UA levels showed signs of stabilization,the difference was not statistically significant (P >0.05).Conclusion Serum UA levels at pathogenesis in hip fracture patients with DVT or PTE are elevated,but as their condition stabilizes,UA levels gradually drop to stable levels.Thus,testing serum UA levels at pathogenesis has clinical significance,as rising UA levels can indicate imminent DVT or PTE formation.%目的：探讨：髋部骨折患者血清尿酸（uric acid，UA）水平与下肢深静脉血拴（deep venous thrombosis， DVT）及肺栓塞形成的相关性。方法：选取295例髋部骨折患者，以患者出院时状态分为三组，其中包括：42例 DVT 栓子脱落造成的肺栓塞（pulmonary thromboembolism，PTE）组；121例 DVT 组；132例单纯髋部骨折对照组。3组均有低分子肝素抗凝基础，PTE、DVT 组于发病时加用一次低分子肝素加强抗凝，并监测此两组入院时、发病及治疗3周各组每周 UA水平；对对照组则检测入院后每周 UA 水平。结果：3组患者入院时 UA 水平组间差异无统计学意义（P ＞0.05）；发病时的 UA 水平，PTE 组明显高于 DVT 组及对照组，DVT 组亦高于对照组，差异无统计学意义（P ＜0.05）；随着病情逐渐稳定，PTE 组及 DVT 组 UA 水平逐渐下降致稳定水平，但与对照组相比，差异无统计学差异（P ＞0.05）；对照组则在入院时UA 水平偏高，监测3周后 UA 水平降低呈稳定趋势，差异无统计学意义（P ＞0.05）。结论：髋部骨折伴有 DVT 或 PTE 患者，发病时血浆 UA 水平均较高，随病情日趋稳定，UA 水平逐渐下降至稳定。发病时血尿酸检测有一定临床意义，UA 水平升高应警惕 DVT、PTE 的产生。