Study On The Diagnostic Value Of Laboratory Indicators For Venous Thromboembolism

Objective:This study retrospectively analyzed changes in laboratory testing indicators of VTE and its subgroups,explored the correlation and diagnostic value between these indicators and VTE and its subgroups,and provided reference value for the diagnosis and treatment of VTE.Methods:In this particular research,341 hospitalized VTE patients admitted to the First Hospital of Lanzhou University from April 2021 to May 2022 were enrolled as the experimental group,and 302 non-VTE patients who were hospitalized during the same period were enrolled as the control group.General clinical data and laboratory testing indicators were collected for all patients in both groups.Based on whether or not they had pulmonary embolism(PE),VTE patients were divided into a deep vein thrombosis(DVT)subgroup without PE(249 cases)and a PE subgroup(92cases).One-way ANOVA,Kruskal-Waliis H test,and chi-square test were used for inter-group comparison,and Spearman correlation analysis was performed to evaluate the correlation between laboratory testing indicators and VTE and PE.Multivariate logistic regression analysis was used to identify independent risk factors and assess the risk of developing VTE and PE.The receiver operating characteristic(ROC)curve was used to evaluate diagnostic performance,and the area under the curve(AUC)was compared to analyze its diagnostic value.Results:After statistical analysis of the enrolled patients,the following findings were revealed:1.Inter-group comparison:(1)Compared with the control group,the DVT subgroup showed statistically significant increased levels of PT,INR,APTT,TT,FIB,FDP,D-D,CRP,WBC,NEUT%,MONO%,RDW-SD,LDH,α-HBDH,FERR,BNP,hsTnI,and LA,while RBC,Hb,HCT,LYM%,PDW,MPV,IBIL,Ca,TC,LDL-C,apoA1,apoB,and HDL-C showed statistically significant decreased levels(P<0.05),and other indicators showed no statistically significant differences(P>0.05).(2)The PE subgroup had higher levels of PT,INR,APTT,FIB,FDP,D-D,CRP,WBC,NEUT%,RDW-SD,DBIL,LDH,α-HBDH,FERR,BNP,hsTnI,MYO,and LA,and lower levels of RBC,LYM%,MPV,Ca,TG,TC,LDL-C,apo AI,and HDL-C,with statistically significant differences(P<0.05),while other indicators showed no statistically significant differences(P>0.05).(3)The VTE group had higher levels of PT,INR,APTT,TT,FIB,FDP,D-D,CRP,WBC,NEUT%,MONO%,RDW-SD,LDH,α-HBDH,FERR,BNP,hsTnI,and LA,and lower levels of RBC,Hb,HCT,LYM%,PDW,MPV,IBIL,Ca,TG,TC,LDL-C,apoA1,apoB,and HDL-C,showing statistically significant differences(P<0.05)except for other indicators that showed no statistically significant differences(P>0.05).(4)In the VTE group,compared with the DVT subgroup,the PE subgroup had higher levels of INR,FDP,CRP,WBC,NEUT%,DBIL,BNP,and hsTnI,and lower levels of RBC,Hb,HCT,LYM%,and apoA1,which exhibited statistically significant differences(P<0.05),while other indicators showed no statistically significant differences(P>0.05).2.Spearman correlation analysis was performed to investigate the correlation between laboratory indicators and the occurrence of VTE and PE.Results showed:(1)PT,INR,APTT,TT,FIB,FDP,D-D,CRP,WBC,NEUT%,LYM%,MONO%,RDW-SD,LDH,α-HBDH,FERR,BNP,hsTnI,and LA were positively correlated with the incidence of VTE.RBC,Hb,HCT,PDW,MPV,IBIL,Ca,TG,TC,LDL-C,apoA1,and HDL-C were negatively correlated with the incidence of VTE.Among them,D-D(r_s=0.706,P<0.001)showed a strong correlation with the incidence of VTE.(2)Within the VTE group,PT,INR,FIB,FDP,D-D,CRP,RBC,Hb,HCT,WBC,NEUT%,DBIL,Crea,LDH,α-HBDH,BNP,hsTnI,and LA were positively correlated with the incidence of PE.LYM%and apoA1 were negatively correlated with the incidence of PE.3.The results of the multivariate logistic regression analysis showed:(1)PT,D-D,CRP,and RDW-SD were risk factors for VTE,while MPV,Ca,and HDL-C were protective factors for VTE.According to the ROC curve,it was found that D-D had the highest diagnostic value for VTE,with an AUC of 0.913,sensitivity of 84.8%,specificity of 90.2%,and a critical value of 0.645μg/m L.The combination diagnosis yielded an AUC of 0.961,sensitivity of 88.4%,and specificity of 92.2%.(2)HCT,NEUT%,and BNP were risk factors for DVT patients with PE.The ROC curve showed that the AUC for the combined diagnosis of PE was 0.739,with a sensitivity of 74.7%and specificity of 64.2%.Conclusion:1.Testing coagulation,blood routine,biochemical,cardiac markers,lupus anticoagulant and other indicators of hospitalized patients can help early identification of patients at high risk of developing VTE;these indicators also have certain clinical diagnostic value in distinguishing different types of VTE.2.PT,D-D,CRP,and RDW-SD are risk factors for VTE,while MPV,Ca,and HDL-C are protective factors for VTE.Among them,D-D has the highest diagnostic value for VTE,and the combination of the above indicators has high diagnostic value for predicting the incidence of VTE in hospitalized patients.3.HCT,NEUT%,and BNP are risk factors for DVT patients with PE.The combination diagnosis of the above indicators has certain value in identifying patients at high risk of developing PE.Laboratory indicators provide new diagnostic basis and insights,which can assist in the early identification of high-risk VTE patients and different subgroups for warning and differential diagnosis.