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 ),plasmin-antiplasmin complex(PIC),tissue plasminogen activator/plasminogen activator inhibitor-1 complex(tPAI-C), D-direct (D-D),and fibrin degradation products (FDP).Methods A total of 66patients with DVT were enrolled from Renji Hospital.Among them,32patients were at chronic phase of DVT and 34patients were at acute phase of DVT.D-D and FDP were measured by Sysmex CS5100automated coagulation analyzer,while TAT,TM,PIC,and tPAI-C were detected by Sysmex HISCL5000chemiluminescence immunoassay analyzer.At the same time,40samples from healthy physical examination were collected as normal controls.Data were analyzed using SPSS 11.0software.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
作者
沈薇
周景艺
顾怡
沈文艳
李敏
SHEN Wei;ZHOU Jing-yi;GU Yi;SHEN Wen-yan;LI Min(Department of Clinical Laboratory,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)
出处
《血栓与止血学》
2018年第6期905-908,共4页
Chinese Journal of Thrombosis and Hemostasis
基金
国家自然科学基金青年项目(项目编号81601822和81702069)
