The value of platelet parameters, fibrinogen and D-dimer in the diagnosis of deep vein thrombosis

Objective　To investigate the diagnostic value of platelet parameters, fibrinogen (Fib) and D-dimer for deep venous thrombosis (DVT). Methods　Six hundred and sixty-seven patients with DVT hospitalized in the Peripheral Vascular Disease Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from June 2014 to June 2019 were selected as the observation group, and 200 outpatients without DVT were selected as the control group. The general data, platelet parameters [platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet hematocrit (PCT) and platelet-large cell ratio (P-LCR)], FIB and D-dimer of the subjects were collected, and the differences in the above indexes were compared between the two groups. Logistic regression was used to analyze the risk factors of DVT, Pearson correlation was used to analyze the relation between PLT, MPV, PDW, PCT, P-LCR, Fib and D-dimer, and area under ROC curve (AUC) were used to analyze the diagnostic value of the above indexes for DVT. Results　Compared with control group, the levels of MPV, PDW and P-LCR of DVT group decreased (P<0.05), the levels of Fib and D-dimer of DVT group increased, and the differences were statistically significant (P<0.05). Fib and D-dimer were not only risk factors of DVT (OR=1.493, 28.154, P<0.05), but also independent risk factors of DVT (OR=1.739, 4.837, P<0.01); P-LCR was the protective factor of DVT (OR=0.914, P<0.05). PLT was negatively correlated with MPV, PDW and P-LCR (r=–0.269, –0.233, –0.120, P<0.01), positively correlated with PCT (r=0.062, P<0.01); MPV was positively correlated with PDW and P-LCR (r=0.945, 0.597, P<0.01); PDW was positively correlated with P-LCR (r=0.582, P<0.01) and negatively correlated with D-dimer (r=–0.551, P<0.01). MPV, PDW, P-LCR and Fib had low diagnostic value for DVT (AUC was 0.588, 0.606, 0.588 and 0.699, P<0.01), and D-dimer had medium diagnostic value (AUC was 0.882, P<0.01); MPV, PDW and P-LCR combined with Fib could improve the sensitivity of Fib diagnosis alone (53.3%-54.7% vs. 49.6%), and combined with D-dimer could improve the specificity of D-dimer diagnosis alone (88.1%-89.0% vs. 81.4%). Conclusion　Platelet parameters (MPV, PDW, P-LCR), Fib and D-dimer have certain reference value for clinical diagnosis and disease condition evaluation of DVT. DOI: 10.11855/j.issn.0577-7402.2021.09.10