摘要
目的 分析骨折患者围术期血栓早期分子标记物的变化,为血栓早期诊断及治疗提供依据。方法 选取2016年10月-2017年3月在本院进行治疗的90例骨折患者为研究对象,分别在术前和术后24 h进行血栓早期分子标记物凝血酶-抗凝血酶复合物(thrombin-antithrombin complex,TAT)、纤溶酶-α2纤溶酶抑制物复合物(α2-plasmin inhibitor-plasmin complex,PIC)、血栓调节蛋白(thrombomoduline,TM)、组织纤溶酶原激活物/纤溶酶原激活物抑制剂-1复合物(tissue plasminogen activator-plasmingen activator inhibitor complex,tPAIC)检测及常规凝血四项检测,对部分患者进行术后D-二聚体(D-dimer,DD)检测,并同期选取120例健康体检者作为对照组。结果 骨折患者术前TAT、tPAIC、PIC、TM、凝血酶原时间(prothrombin time,PT)均显著高于正常对照(P均<0.001),术后上述指标显著升高,与术前及对照组比较差异均有统计学意义(P均<0.001)。骨折患者凝血酶时间(thrombin time,TT)术前、术后及与对照组比较差异均无统计学意义(P均>0.05)。活化部分凝血活酶原时间(activated partial thromboplastin time,APTT)及血纤蛋白原(fibrinogen,FIB)术后均显著高于术前及对照组(P<0.01)。15例术后TAT/PIC比值高于正常的患者中13例血中D-二聚体水平同时明显升高。结论 检测TAT、PIC、TM、tPAIC、PT,计算TAT/PIC,与DD联合检测可为临床骨折患者血栓早期预警提供诊断依据。
Objective To analyze the changes of early thrombosis molecular markers in fracture patients during perioperative period,and provide evidence for early diagnosis and treatment of thrombosis.Methods Ninety fracture patients who were treated in our hospital from October 2016 to March 2017 were enrolled in this study.Meanwhile,120 healthy subjects were selected as the control group during the same period.Four prethrombosis markers,thrombin-antithrombin complex (TAT),tissue plasminogen activator-plasmingen activator inhibitor complex (tPAIC),α2-plasmin inhibitor-plasmin complex (PIC),thrombomoduline (TM),and routine coagulation (prothrombin time PT,activated partial thromboplastin time APTT,thrombin time TT,fibrinogen FIB) were detected before operation and at 24 hours after operation,and D-dimer (DD) was detected in some patients after surgery.Results The levels of TAT,PIC,TM,tPAIC and PT in fracture patients before operation were significantly higher than those in the control group,and they all significantly increased after operation (all P<0.001).There was no significant difference in preoperative APTT,FIB between the preoperative group and the normal control group;However,after surgery,APTT and FIB increased,and they were significantly higher than those in the former two groups (all P<0.05).TT showed no significant difference between the preoperative group,the postoperative group,and the normal control.Fifteen patients with elevated TAT/PIC ratio were followed up,and 13 of them had elevated level of D-dimer in blood.Conclusion Detection of TAT,PIC,TM,tPAIC,PT,calculation of TAT/PIC,and combined them with DD may provide predicting evidences for thromboembolic event in fracture patients.
作者
谢玉茹
廖扬
黄东泉
石玉玲
XIE Yuru;LIAO Yang;HUANG Dongquan;SHI Yuling(General Hospital of Southem Theatre Command of PLA,Guangzhou 510010,Guangdong Province,China)
出处
《解放军医学院学报》
CAS
2020年第2期170-173,共4页
Academic Journal of Chinese PLA Medical School
作者简介
谢玉茹,女,博士,主任医师,副院长。研究方向:老年病。Email:xyr19491001@qq.com
