| Objective:To evaluate diagnostic value of plasma D-dimer (D-D) and fibrinogen (Fg) and D-dimer/fibrinogen (D/F) ratio in acute lower extremity deep vein thrombosis (DVT) after artificial joint replacement.Methods:From August 2009 to December 2011,273 patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) were examined by venography of deep vein of lower extremity on postoperative days 3-5. According to the results of angiography images, all study patients were divided into DVT group including 66 patients (15 males and 51 females, median age 66 years) and non-DVT group including 207 patients (70 males and 137 females, median age 63 years). Plasma levels of D-D and Fg were measured preoperatively and postoperatively on days 3-5 by immunoturbidimetry and solidification method, respectively. The differences of plasma levels of D-D and Fg and D/F ratio were analyzed with statistics method between the two groups, respectively. Furthermore, diagnostic value of postoperative plasma D-D and D/F ratio in acute DVT was assessed using a receiver operating characteristic (ROC) curve.Results:There were no statistical significances between the two groups, regarding preoperative plasma levels of D-D and Fg. No significant difference was found in postoperative plasma levels of Fg between the two groups. However, postoperative plasma levels of D-D and D/F ratio increased in the DVT group than in the non-DVT group, and there were significant differences between the two groups. In addition, the ROC curve analysis showed that the area under curve of postoperative plasma D-D and D/F ratio was 0.688 and 0.684, respectively, but this difference did not reach statistical significance.Conclusion:Plasma Fg may be meaningless for the diagnosis of acute DVT after artificial joint replacement. Althought plasma D-dimer and D/F ratio may be useful for screening and diagnosis of acute DVT, the diagnostic accuracy is low. |
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