| 郑桂莲,耿晓慧,张莎莎,等.中性粒细胞胞外陷阱、炎性蛋白水平对全膝关节置换术后下肢深静脉血栓形成预测价值分析[J].安徽医药,2022,26(6):1128-1132. |
| 中性粒细胞胞外陷阱、炎性蛋白水平对全膝关节置换术后下肢深静脉血栓形成预测价值分析 |
| Analysis of the predictive value of neutrophil extracellular traps and inflammatory protein levels for lower extremity deep vein thrombosis after total knee arthroplasty |
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| DOI：10.3969/j.issn.1009-6469.2022.06.015 |
| 中文关键词: 静脉血栓形成 关节成形术，置换，膝 手术后并发症 下肢 中性粒细胞胞外陷阱 C反应蛋白质 巨噬细胞炎性蛋白 1α |
| 英文关键词: Venous thrombosis Arthroplasty, replacement, knee Postoperative complications Lower extremity Neutrophil extracellular trap C-reactive protein Macrophage inflammatory protein 1α |
| 基金项目:2015年河南省重点中医学科专科学术带头人培养项目专项课题( 2015ZY03008) |
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| 中文摘要: |
| 目的探究中性粒细胞胞外陷阱( NETs)、炎性蛋白水平对全膝关节置换术后下肢深静脉血栓形成( DVT)的预测价值。方法选取河南省洛阳正骨医院 2018年 1月至 2019年 6月全膝关节置换术病人 110例，根据是否伴有 DVT分为观察组 36例( DVT病人)及对照组 74例(无 DVT病人)。比较两组术前、术后 1d、术后 3d血清 NETs(吸光度)、炎性蛋白［ C反应蛋白(CRP)、巨噬细胞炎性蛋白 1α(MIP-1α)］水平， logistic回归分析全膝关节置换术后下肢 DVT的影响因素，受试者工作特征(ROC)曲线分析血清 NETs、CRP、MIP-1α对下肢 DVT的预测价值。结果两组年龄、体质量指数( BMI)、合并内科疾病比例差异有统计学意义( P<0.05)；观察组术后 1d、术后 3d血清 NETs［( 0.52±0.16)、(0.26±0.08)］、 CRP［( 35.27±11.74)mg/L、(19.64± 6.55)mg/L］、 MIP-1α［( 38.09±12.68)ng/L、(21.07±7.02)ng/L］水平高于对照组［( 0.38±0.13)、(0.37±0.13)］、［( 25.28±8.42)mg/L、(13.16±4.37)mg/L］、［(26.63±8.84)ng/L、(15.22±5.10)ng/L］均差异有统计学意义( P<0.05)；年龄、合并内科疾病、 BMI、术后 3d血清 NETs、CRP、MIP-1α水平是全膝关节置换术后下肢 DVT的，重要影响因素( P<0.05)；各指标预测术后下肢 DVT的 ROC曲线结果显示，术后 3d血清 CRP预测下肢 DVT的灵敏度最高( 0.833)而术后 3d联合检测预测下肢 DVT的特异度、准确度、约登指数和 AUC值最高，分别为 0.784、0.791、0.590、0.883。结论 NETs、C，RP、MIP-1α在全膝关节置换术后 DVT病人中呈高表达， |
| 英文摘要: |
| Objective To investigate the predictive value of neutrophil extracellular traps (NETs) and inflammatory protein levelson lower extremity deep vein thrombosis (DVT) after total knee arthroplasty.Methods A total of 110 patients with total knee arthroplasty from January 2018 to June 2019 at Luoyang Orthopaedic Hospital in Henan Province were selected and divided into 36 cases inthe observation group (patients with DVT) and 74 cases in the control group (patients without DVT) according to whether they were accompanied by DVT. The levels of serum NETs (absorbance), inflammatory proteins [C-reactive protein (CRP), macrophage inflammatory protein 1α (MIP-1α)] before, 1 d and 3 d after surgery were compared between the two groups, and the factors influencing DVT formation after total knee arthroplasty were analyzed by logistic regression, and the subject operating characteristic (ROC) curves were analyzed for serum NETs, CRP, and MIP-1α on DVT The predictive value of DVT formation.Results There were statistically significantdifferences in age, body mass index (BMI), and proportion of comorbid medical diseases between the two groups (P < 0.05). The levels of serum NETs [(0.52±0.16) , (0.26±0.08)], CRP [(35.27±11.74) mg/L, (19.64±6.55) mg/L], and MIP-1α [(38.09±12.68) ng/L, (21.07±7.02) ng/L] in the observation group at 1 d and 3 d postoperatively were higher than those in the control group [(0.38±0.13) , (0.37±0.13)], [(25.28±8.42) mg/L, (13.16±4.37) mg/L], [(26.63±8.84) ng/L, (15.22±5.10) ng/L] , with statistically significant differences (P< 0.05). Age, comorbid medical disease, BMI, and serum NETs, CRP, and MIP-1α levels at 3 d postoperatively were significant influencing factors for DVT formation after total knee arthroplasty (P < 0.05). The results of ROC curves for each index to predict postoperativeDVT formation showed that serum CRP at 3 d postoperatively had the highest sensitivity (0.833) in predicting DVT formation, while thecombined assay at 3 d postoperatively had the highest specificity, accuracy, Jorden index, and AUC values of 0.784, 0.791, 0.590, and0.883, respectively, in predicting DVT formation.Conclusions NETs, CRP, and MIP-1α are highly expressed in patients with DVT after total knee arthroplasty, which are significantly correlated with DVT occurrence, and have a predictive value for DVT occurrence. Inparticular, the combined detection of the three have higher predictive efficacy, and targeting NETs, CRP, and MIP-1α may provide a new idea for the prevention and treatment of DVT. |
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