| 索敏敏,于海东,薛娟,等.血浆 TAT、NETs、sCD40L联合对恶性肿瘤病人深静脉血栓的预测价值[J].安徽医药,2025,29(12):2465-2469. |
| 血浆 TAT、NETs、sCD40L联合对恶性肿瘤病人深静脉血栓的预测价值 |
| Predictive value of the combination of plasma TAT, NETs, and sCD40L for deep vein thrombosis in patients with malignant tumors |
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| DOI：10.3969/j.issn.1009-6469.2025.12.028 |
| 中文关键词: 恶性肿瘤 深静脉血栓 凝血酶 -抗凝血酶复合物 中性粒细胞外诱捕网 可溶性 CD40配体 |
| 英文关键词: Malignant tumors Deep vein thrombosis Thrombin antithrombin complex Neutrophil extracellular traps Soluble CD40 ligand |
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| 中文摘要: |
| 目的探讨恶性肿瘤病人血浆凝血酶 -抗凝血酶复合物( TAT)、中性粒细胞外诱捕网( NETs)、可溶性 CD40配体(sCD40L)表达水平及其对深静脉血栓的预测价值。方法前瞻性选取 2021年 1月至 2023年 3月华北医疗健康集团峰峰总医院住院治疗的 239例恶性肿瘤病人为观察组，根据住院期间是否并发深静脉血栓分为血栓组 52例和无血栓组 187例，根据 Khorana评分评估病人深静脉血栓风险并分为低风险组 134例、中风险组 57例、高风险组 48例；选取在该院常规检查的 246例健康体检者作为健康组。采用化学发光免疫分析法检测血浆 TAT、NETs、sCD40L水平；采用多因素 logistic回归分析筛选恶性肿瘤病人并发深静脉血栓的影响因素；采用受试者操作特征曲线( ROC曲线)分析血浆 TAT、NETs、sCD40L水平对恶性肿瘤病人并发深静脉血栓的预测价值。结果观察组血浆 TAT(15.04±3.78)μg/L、NETs(82.51±20.16)μg/L、sCD40L(210.04±26.38) ng/L水平高于健康组［( 2.48±0.59)μg/L、(26.73±6.14)μg/L、(62.45±15.75)ng/L］(P<0.05)。高风险组血浆 TAT(20.27±5.30)μg/ L、NETs(121.42±33.78)μg/L、sCD40L(272.65±48.91)ng/L水平高于中风险组［( 16.44±4.21)μg/L、(81.07±21.13)μg/L、(205.66± 35.34)ng/L］和低风险组［( 12.57±2.32)μg/L、(69.19±17.92)μg/L、(189.48±20.95)ng/L］，中风险组血浆 TAT、NETs、sCD40L水平高于低风险组( P<0.05)。血栓组血浆 TAT(17.99±3.40)μg/L、NETs(104.51±29.46)μg/L、sCD40L(241.15±42.89)ng/L水平及住院时间、肿瘤分期 Ⅲ/Ⅳ期病人比例高于无血栓组［( 14.22±2.94)μg/L、(76.50±19.34)μg/L、(201.39±28.83)ng/L］(P<0.05)。 TAT、NETs、sCD40L是恶性肿瘤病人并发深静脉血栓的独立危险因素( P<0.05)。血浆 TAT、NETs、sCD40L水平单独及联合预测恶性肿瘤病人并发深静脉血栓的曲线下面积( AUC)分别为 0.80、0.79、0.73、0.90。结论 TAT、NETs、sCD40L均可较准确地预测恶性肿瘤病人深静脉血栓发生风险，三者联合的预测效能更高。 |
| 英文摘要: |
| Objective To investigate the expression levels of plasma thrombin-antithrombin complex (TAT), neutrophil extracellulartraps (NETs), and soluble CD40 ligand (sCD40L) in patients with malignant tumors and their predictive value for deep vein thrombosis.Methods Two hundred and thirty-nine patients with malignant tumor who were hospitalized at Fengfeng General Hospital of NorthChina Medical and Health Group from January 2021 to March 2023, were prospectively included as the observation group. Accordingto whether deep vein thrombosis occurred during hospitalization, there were 52 cases in the thrombosis group and 187 cases in the non-thrombosis group. According to the Khorana scores, patients were evaluated for the risk of deep vein thrombosis and assigned to a lowrisk group (n=134) a medium risk group (n=57), or a high risk group (n=48); 246 healthy individuals who underwent routine examina-tions in the same hospital were collected as the healthy group. The chemiluminescence immunoassay was applied to detect plasmaTAT, NETs and sCD40L levels. Multivariate Logistic regression was applied to screen the influencing factors for deep vein thrombosisin malignant tumor patients; receiver operating characteristic (ROC) curve was applied to analyze the predictive value of plasma levelsof TAT, NETs, and sCD40L for deep vein thrombosis in malignant tumor patients. Results The plasma levels of TAT, NETs, andsCD40L [(15.04±3.78) μg/L, (82.51±20.16) μg/L, (210.04±26.38) ng/L] in the observation group were higher than those in the healthygroup [(2.48±0.59) μg/L, (26.73±6.14) μg/L, (62.45±15.75) ng/L] (P<0.05). The plasma levels of TAT, NETs, and sCD40L [(20.27±5.30) μg/L, (121.42±33.78) μg/L, (272.65±48.91) ng/L] in the high-risk group were higher than those in the medium risk group[(16.44±4.21) μg/L, (81.07±21.13) μg/L, (205.66±35.34) ng/L] and low risk group [(12.57±2.32) μg/L, (69.19±17.92) μg/L, (189.48±20.95) ng/L], while the plasma levels of TAT, NETs, and sCD40L in the medium risk group were higher than those in the low risk group(P<0.05). The plasma levels of TAT, NETs, and sCD40L [(17.99±3.40) μg/L, (104.51±29.46) μg/L, (241.15±42.89) ng/L], length of hos-pital stay, and the proportion of stage Ⅲ/Ⅳ tumor patients in the thrombosis group were higher than those in the non-thrombosis group [(14.22±2.94) μg/L, (76.50±19.34) μg/L, (201.39±28.83) ng/L] (P<0.05). TAT, NETs, and sCD40L were independent risk factors for deep vein thrombosis in malignant tumor patients (P<0.05). The areas under the curve (AUC) of plasma TAT, NETs, and sCD40L levelsindividually and in combination for predicting deep vein thrombosis in malignant tumor patients were 0.80, 0.79, 0.73, and 0.90, re.spectively.Conclusion TAT, NETs, and sCD40L can accurately predict the risk of deep vein thrombosis in patients with malignant tu-mors, and the combination of the three markers has higher predictive efficacy. |
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