C-反应蛋白作为深静脉血栓形成生物学观察指标的评价  

Evaluation of the effectiveness of C-reaction protein as a biomarker of deep venous thrombosis of lower limb

作　　者：刘咸罗[1,2,3] 钱小星[1,2,3] 汤永胜[1,2,3] 陈克辉[1,2,3] 钱梅梅[1,2,4] 

机构地区：[1]安徽医科大学第四临床学院 [2]安徽医科大学附属合肥医院 [3]合肥市第二人民医院血管外科,230011 [4]合肥市第二人民医院彩超室,230011

出　　处：《中国医疗前沿》2011年第21期7-8,77,共3页China Healthcare Innovation

基　　金：合肥市重点课题基金资助项目(编号:合科0081008号)

摘　　要：目的评价血液中高敏感性C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)含量,作为下肢深静脉血栓形成的生物学观察指标的可行性。方法⑴动物实验研究:取实验犬8条,于左后肢大腿内侧切开皮肤,显露髂-股静脉1段,长3cm(deep vein thrombosis,DVT段),阻断血流后,注入血凝酶。24h,作患肢顺行静脉造影和彩超检查,确定DVT已形成,与术后每周重复影像学检查,并测定血液中高敏感C-反应蛋白含量,共计6周。⑵2006年1月-2011年1月,共收治膝关节近侧单肢DVT患者102例,其中男性58例,女性44例;年龄24-86岁,平均59.64岁;左下肢79条,右下肢23条,都于发病1周内入院。住院后作抗栓治疗2-3周后出院。于入院时、住院期内和出院后4-6周,分别作静脉造影和彩超检查,并同时检测血液中hsCRP的浓度。结果动物实验显示,彩超能更早、更准确地说明血栓再通的情况;DVT的病情演进与hsCRP的升高和回落呈正相关变化。临床研究显示,69例DVT患者疗效满意,28例好转,5例无效。入院时,血hsCRP为92.90-5.16,平均为29.90±30.40mg/L。出院4周后,hsCRP为45.80-0.93mg/L,平均为7.12±11.40mg/L,hsCRP的升高的情况与DVT的严重程度呈正相关。治疗效果不佳者出院时hsCRP虽下降但仍显著高于正常者。结论血液中hsCRP含量的变化,与DVT的病情演进,呈正相关改变,因此hsCRP可作为DVT的生物学观察指标,引导治疗的全过程,提高疗效,造福患者。Objective To assess the possibility of C-reaction protein to be a biomarker for deep venous thrombosis of lower limb. Methods From January, 2006, Jnauary to 2011, January the DVT moder was established on the ilicfemoral vein of the left hind leg of eight dogs,weighted 20-25kg, by infusion of thrombin and teauma of the vein wall. After surgery, the thrombotic segments were exercised with venography and duplex ultrasound, and the serum hsCRP was also tested every third after surgery for 4 weeks. From 2006, January to 2011, January patients were admitted with diagnosis of acute DVT fou lower limbs. They were treated mainly with urokinase and molecular weight heparin fou 2-3weeks. The assessment of venography, duplex ultrasound and serum hsCRP were performed immediately after admission every fifth day to 4 weeks after discharge. Results After medical therapy fou 2-3weeks, the cinical fetures prominently subsided in patients. Clinical studies show that, 69 cases of patients with DVT results were satisfactory, 28 patients get better, 5 cases is invalid. At admission,the hsCRP was 29.90±30.40mg/L and it dropped to 7.12±11.40mg/L at 4 weeks after discharge. Conclussion The hsCRP was possiblly related to the severity of DVT.It may be used as the biomarker of DVT, in guiding the treatment of DVT.

关 键 词：高敏感性C-反应蛋白 DVT 彩超 静脉造影术 

分 类 号：R659[医药卫生—外科学]