血栓相关凝血标志物在诊断深静脉血栓患者中的应用
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摘要
目的评估凝血标志物凝血酶-抗凝血酶复合物(TAT)、凝血酶调制蛋白(TM)、纤溶酶-抗纤溶酶复合物(PIC)、组织型纤溶酶原激活物/纤溶酶原激活物抑制剂-1复合物(t PAI-C)、D二聚体(D-D)、纤维蛋白降解产物(FDP)在深静脉血栓患者中的应用。方法利用仁济医院收集的深静脉血栓(DVT)患者样本66例,32例为慢性期DVT,34例为急性期DVT检测凝血标志物。使用SYSMEX CS5100血凝分析仪测定D-D和FDP,使用SYSMEX HISCL5000化学发光免疫分析仪测定TAT、TM、PIC、t PAI-C,均为配套试剂。同时选取40例健康体检样本作为正常对照。数据用SPSS11.0软件分析。结果慢性期DVT患者,D-D、FDP、TAT、TM、PIC、t PAI-C均值分别为(0.079±0.093)μg/ml、(1.60±2.41)μg/ml、(3.36±3.73) ng/ml、(9.89±2.13) TU/ml、(1.008±1.096) ug/ml、(9.83±3.84) ng/ml;急性期DVT患者,D-D、FDP、TAT、TM、PIC、t PAI-C均值分别为(2.47±2.80)μg/ml、(32.6±42.11)μg/ml、(17.64±18.35) ng/ml、(9.74±3.01) TU/ml、(5.658±6.974) ug/ml、(11.58±6.52) ng/ml;正常对照组,D-D、FDP、TAT、TM、PIC、t PAI-C均值分别为(0.073±0.088)μg/ml、(1.62±2.49)μg/ml、(2.60±1.13) ng/ml、(8.08±1.49) TU/ml、(0.459±0.105) ug/ml、(5.59±2.25) ng/ml。组间比较显示,急性和慢性期DVT间有统计学差异(P <0.05水平)的指标为D-D、FDP、TAT、PIC。正常组和急性期DVT间有统计学差异(P <0.05水平)的指标为D-D、FDP、TAT、TM、PIC、t PAI-C;正常组和慢性期DVT间有统计学差异(P <0.05水平)的指标为TM、t PAI-C。结论对于诊断急性DVT来说,D-D、FDP、TAT、TM、PIC、t PAI-C这6项指标均有良好的诊断价值;慢性DVT患者相对于正常人群而言,TM、t PAI-C表现增高,说明血栓后血管修复是一个漫长持续的过程,而对于急性期DVT而言,D-D、FDP、TAT、PIC下降明显,对于DVT的诊断和治疗有良好的指导意义。
Objective To evaluate the application of coagulation markers in patients with deep venous thrombosis(DVT),including thrombin-antithrombin complex(TAT),thrombomodulin(TM),plasminantiplasmin complex(PIC),tissue plasminogen activator/plasminogen activator inhibitor-1 complex(tPAI-C),D-dimer(D-D),and fibrin degradation products(FDP).Methods A total of 66 patients with DVT were enrolled from Renji Hospital.Among them,32 patients were at chronic phase of DVT and 34 patients were at acute phase of DVT.D-D and FDP were measured by Sysmex CS5100 automated coagulation analyzer,while TAT,TM,PIC,and tPAI-C were detected by Sysmex HISCL5000 chemiluminescence immunoassay analyzer.At the same time,40 samples from healthy physical examination were collected as normal controls.Data were analyzed using SPSS 11.0 software.Results The mean values of D-D,FDP,TAT,TM,PIC,and tPAI-C were(0.079 ± 0.093) μg/ml,(1.60 ± 2.41) μg/ml,(3.36 ± 3.73) ng/ml,(9.89 ± 2.13) TU/ml,(1.008 ±1.096) ug/ml and(9.83 ± 3.84) ng/ml in patients with chronic DVT;(2.47 ± 2.80) μg/ml,(32.6 ±42.11) μg/ml,(17.64 ± 18.35) ng/ml,(9.74 ± 3.01) TU/ml,(5.658 ± 6.974) ug/ml and(11.58 ± 6.52)ng/ml in patients with acute DVT; and(0.073 ± 0.088) μg/ml,(1.62 ± 2.49) μg/ml,(2.60 ± 1.13) ng/ml,(8.08 ± 1.49) TU/ml,(0.459 ± 0.105) ug/ml and(5.59 ± 2.25) ng/ml in the normal control group,respectively.Statistically significant differences(P < 0.05) were identified in D-D,FDP,TAT and PIC between acute and chronic DVT,in D-D,FDP,TAT,TM,PIC,and tPAI-C between normal control and acute DVT,and in TM and tPAI-C between normal control and chronic DVT.Conclusion D-D,FDP,TAT,TM,PIC,and tPAI-C have good diagnostic values for the diagnosis of acute DVT.Patients with chronic DVT have higher levels of TM and tPAI-C than normal people,indicating that blood vessel repair after thromboembolism is a long and continuous process.However,D-D,FDP,TAT and PIC decreased significantly in patients with chronic DVT,compared with those with acute DVT.The combined application of these indicators has a good clinical application significance for the diagnosis and treatment.
Objective To evaluate the application of coagulation markers in patients with deep venous thrombosis(DVT),including thrombin-antithrombin complex(TAT),thrombomodulin(TM),plasminantiplasmin complex(PIC),tissue plasminogen activator/plasminogen activator inhibitor-1 complex(tPAI-C),D-dimer(D-D),and fibrin degradation products(FDP).Methods A total of 66 patients with DVT were enrolled from Renji Hospital.Among them,32 patients were at chronic phase of DVT and 34 patients were at acute phase of DVT.D-D and FDP were measured by Sysmex CS5100 automated coagulation analyzer,while TAT,TM,PIC,and tPAI-C were detected by Sysmex HISCL5000 chemiluminescence immunoassay analyzer.At the same time,40 samples from healthy physical examination were collected as normal controls.Data were analyzed using SPSS 11.0 software.Results The mean values of D-D,FDP,TAT,TM,PIC,and tPAI-C were(0.079 ± 0.093) μg/ml,(1.60 ± 2.41) μg/ml,(3.36 ± 3.73) ng/ml,(9.89 ± 2.13) TU/ml,(1.008 ±1.096) ug/ml and(9.83 ± 3.84) ng/ml in patients with chronic DVT;(2.47 ± 2.80) μg/ml,(32.6 ±42.11) μg/ml,(17.64 ± 18.35) ng/ml,(9.74 ± 3.01) TU/ml,(5.658 ± 6.974) ug/ml and(11.58 ± 6.52)ng/ml in patients with acute DVT; and(0.073 ± 0.088) μg/ml,(1.62 ± 2.49) μg/ml,(2.60 ± 1.13) ng/ml,(8.08 ± 1.49) TU/ml,(0.459 ± 0.105) ug/ml and(5.59 ± 2.25) ng/ml in the normal control group,respectively.Statistically significant differences(P < 0.05) were identified in D-D,FDP,TAT and PIC between acute and chronic DVT,in D-D,FDP,TAT,TM,PIC,and tPAI-C between normal control and acute DVT,and in TM and tPAI-C between normal control and chronic DVT.Conclusion D-D,FDP,TAT,TM,PIC,and tPAI-C have good diagnostic values for the diagnosis of acute DVT.Patients with chronic DVT have higher levels of TM and tPAI-C than normal people,indicating that blood vessel repair after thromboembolism is a long and continuous process.However,D-D,FDP,TAT and PIC decreased significantly in patients with chronic DVT,compared with those with acute DVT.The combined application of these indicators has a good clinical application significance for the diagnosis and treatment.
引文
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