摘要
目的探讨活化蛋白C抗体(APCR)、抗心磷脂抗体(ACA)、P-选择素(P-selectin)的表达与下肢创伤性骨折患者深静脉血栓(DVT)形成的关系。方法2016年1月—2018年6月广东省中山市中医院骨二科手术治疗下肢创伤性骨折患者301例,男性134例,女性167例;年龄20~65岁,平均38.2岁。按有无发生DVT分为DVT组15例和无DVT组286例,对两组患者临床资料进行分析,术前、术后1、3d采集患者外周空腹静脉血,采用[APTT±APC(Dahlback)]法测定血浆APCR表达情况,用酶联免疫法测定血清ACA表达情况、用酶联免疫法测定血浆P-selectin及D-D表达情况,比较各组APCR、ACA、P-selectin的表达。结果DVT组术前、术后1、3d APCR阳性率、ACA阳性率、D-D阳性率、P-selectin及D-D水平均高于同期无DVT组(P<0.05),两组患者术后1、3d APCR阳性率、ACA阳性率、D-D阳性率、P-selectin及D-D水平均高于术前,组间及组内比较差异均有统计学意义(P<0.05)。经Logistic回归分析发现,APCR阳性率、ACA阳性率、P-selectin、D-D水平及D-D阳性率是下肢创伤性骨折DVT发生的独立危险因素。APCR阳性率及ACA阳性率和D-D阳性率,P-selectin水平和D-D水平均呈正相关,r值分别为0.651、0.589、0.638。结论APCR、ACA、P-selectin和下肢创伤性骨折患者DVT有良好相关性,可作为其监测指标,以降低围手术期风险。
Objective To explore the relationship between the expression of activated protein C antibody(APCR),anticardiolipin antibody(ACA)and P-selectin and the formation of deep venous thrombosis(DVT)in patients with traumatic fracture of lower limbs.Methods From Jan.2016 to Jun.2018,301 patients with traumatic fracture of lower limbs were treated in Department of Bone Surgery in Zhongshan Hospital of Traditional Chinese Medicine.There were 134 males and 167 females,aged 20-65 years,with a mean age of 38.19 years.According to whether DVT occurred or not,the patients were divided into DVT group(n=15)and non-DVT group(n=286).The clinical data of the two groups were analyzed.Peripheral fasting venous blood was collected from patients before surgery,1 day after surgery and 3 days after surgery.Plasma APCR expression was measured by APTT±APC(Dahlback)method,serum ACA expression,plasma p-selectin and D-D expression was measured by Elisa,and the expressions of APCR,ACA and p-selectin in each group were compared.Results The APCR positive rate,ACA positive rate,D-D positive rate,P-selectin and D-D level in DVT group was higher than those in non-DVT group at the same time point(P<0.05).The APCR positive rate,ACA positive rate,D-D positive rate,P-selectin and D-D level in the two groups were higher than those before operation at the 1st day,3rd day after operation(P<0.05).Logistic regression analysis showed that the positive rate of APCR,ACA,P-selectin,D-D level and D-D positive rate were independent risk factors for DVT of lower limb traumatic fracture.APCR positive rate,ACA positive rate and D-D positive rate,P-selectin level and D-D level were positively correlated,with r values of 0.651,0.589 and 0.638,respectively.Conclusion APCR,ACA,P-selectin and DVT in patients with lower limb traumatic fracture have good correlation and can be used as monitoring indicators to reduce perioperative risks.
作者
林毅秋
丁娣
LIN Yi-qiu;DING Di(Department of Orthopedics,Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan,Guangdong 528400,China)
出处
《创伤外科杂志》
2019年第12期916-919,924,共5页
Journal of Traumatic Surgery
关键词
下肢骨折
活化蛋白C抗体
抗心磷脂抗体
P-选择素
深静脉血栓
fracture of lower limbs
active protein c antibody
anticardiolipin antibody
P-selectin
deep vein thrombosis
