摘要
目的探讨TAT、PIC、TM及tPAI-C四个抗凝-纤溶标志物联合检测在髋关节置换术后静脉血栓的诊断效能及对疗效的评估价值。方法选取2017年10月至2018年3月于我院完成髋关节置换术的84例患者作为研究对象,根据是否并发静脉血栓分为实验组(并发)和对照组(未并发),分别为48例和36例。采用高敏化学发光法检测两组患者手术前后凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α2纤溶酶抑制物复合物(PIC)、血栓调节蛋白(TM)及组织型纤溶酶原激活物抑制剂复合物(tPAI-C);绘制各单项和联合标志物对髋关节置换术后静脉血栓ROC曲线;统计实验组疗效,并分析抗凝-纤溶标志物与疗效之间的相关性。结果术前,两组患者各项抗凝-纤溶标志物差异无统计学意义(P>0. 05);术后,实验组各项抗凝-纤溶标志物均明显高于对照组,差异具有统计学意义(均P<0.001)。ROC曲线显示,各抗凝-纤溶单项标志物对髋关节置换术后静脉血栓均有一定的诊断价值,以t-PAI-C诊断效能最佳,余下依次为PIC、TAT及TM;与各单项检测比较,四组抗凝-纤溶标志物联合检测诊断效能明显提高。治疗后,经评估示实验组总有效者为45例,有效率为93.75%;经Pearson相关分析示,抗凝-纤溶标志物四组联合检测结果与术后静脉血栓疗效呈正相关(r=0. 715,P=0.006)。结论 TAT、PIC、TM及tPAI-C四个新型抗凝-纤溶标志物联合检测可明显提高髋关节置换术后静脉血栓的诊断效能,且与其疗效呈正相关,值得推广运用。
Objective To explore the diagnosis and efficiency evaluation value of the application of combined anticoagulation and fibrinolytic markers in venous thrombosis after hip replacement. Methods 84 cases of hip arthroplasty in our hospital from January 2014 to January 2017 were selected as the research subjects.They were then divided into the experimental group(concurrent)and the control group(uncomplicated),which were 48 cases and 36 cases respectively.The high sensitive chemiluminescence was used to detect the complex of thrombin antithrombin,plasmin inhibitor complex,thrombomodulin and tissue plasminogen activator inhibitor complex in the two groups of patients before and after the operation.The ROC curves of venous thrombosis after hip arthroplasty were plotted by single and combined markers.The effect of the experimental group was statistically analyzed,and the correlation between the anticoagulation fibrinolysis markers and the curative effect was analyzed. Results There were no significant differences in anticoagulation fibrinolytic markers between the two groups before the operation( P >0.05).After the operation,the anticoagulation fibrinolysis markers(TAT,PIC,TM and tPAI-C)in the experimental group were significantly higher than those of the control group,( P 0x0E?Symbol|@@0x0F0.001).The ROC curve showed that all the anticoagulation and fibrinolysis markers had certain diagnostic value for the venous thrombosis after hip replacement.The diagnosis of t-PAI-C was the best,followed with PIC,TAT and TM.Compared with the individual tests,the combined detection of anticoagulation and fibrinolysis markers in the four groups improved significantly.After the treatment,45 cases were found to be effective in the experimental group,and the effective rate was 93.75%.Using the Person correlation analysis,the results of anticoagulation and fibrinolytic marker in the four groups were positively correlated with the effect of postoperative venous thrombosis( r =0.715, P =0.006). Conclusion The combined detection of four new a
作者
黄声淳
张劲丰
蔡惠兴
吴英
简少珍
吕微风
HUANG Sheng-chun;ZHANG Jin-feng;CAI Hui-xing;WU Ying;JIAN Shao-zhen;LV Wei-feng(Foshan City Chinese Hospital Inspection Medical Center,Foshan 528000,China)
出处
《标记免疫分析与临床》
CAS
2019年第2期294-298,共5页
Labeled Immunoassays and Clinical Medicine
关键词
髋关节置换术
静脉血栓
标志物
诊断
疗效
Hip replacement
Venous thrombosis
Markers
Diagnosis
Efficiency
