中性粒细胞胞外诱捕网水平与全髋关节置换术后下肢深静脉血栓形成相关性  

CORRELATION BETWEEN LEVELS OF NEUTROPHIL EXTRACELLULAR TRAPS AND LOWER EXTREMITY DEEP VENOUS THROMBOSIS AFTER TOTAL HIP ARTHROPLASTY

作　　者：张银龙[1] 崔玉凤[2] 李树锋[3] 

机构地区：[1]河南省焦作煤业(集团)有限公司中央医院骨科,河南焦作454000 [2]河南省商丘医学高等专科学校 [3]山东省千佛山医院

出　　处：《齐鲁医学杂志》2017年第3期311-314,共4页Medical Journal of Qilu

基　　金：山东省自然科学基金面上项目(ZR2014HM049)

摘　　要：目的探讨中性粒细胞胞外诱捕网(NETs)水平与全髋关节置换术后下肢深静脉血栓形成(DVT)相关性。方法选取行全髋关节置换术病人113例,发生DVT 31例(DVT组),无DVT发生82例(非DVT组)。收集两组病人临床资料和围术期资料,并分别于术前24h以及术后24h、72h和5d时,应用基于PicoGreen荧光染料的方法检测血清中dsDNA/NETs水平,应用受试者工作特征曲线(ROC曲线)分析术后各时点dsDNA/NETs水平预测术后发生下肢DVT的价值。结果 DVT组病人术后24h和72h时血清dsDNA/NETs水平均高于非DVT组,差异有统计学意义(t=4.002、5.993,P<0.05)。与术前24h相比,两组病人术后24、72h时血清dsDNA/NETs水平均升高(F=27.023、43.575,P<0.05),而术后5d差异无显著性(P>0.05)。ROC曲线显示,术后24h时血清dsDNA/NETs水平预测DVT发生的曲线下面积为0.837(95%CI=0.763~0.911),当dsDNA/NETs取0.46mg/L时,诊断DVT发生的灵敏度为87.1%,特异度为70.7%;术后72h时血清dsDNA/NETs水平预测DVT发生的曲线下面积为0.647(95%CI=0.526~0.767),当dsDNA/NETs取0.39mg/L时,诊断DVT发生的灵敏度为45.2%,特异度为86.6%。结论全髋关节置换术后病人血清NETs升高可能参与了下肢DVT发生,有望成为早期预测和筛查全髋关节置换术后下肢DVT的潜在生物学指标。Objective To investigate the correlation between the levels of neutrophil extracellular traps（NETs）and lower extremity deep venous thrombosis（DVT）after total hip arthroplasty. Methods A total of 113 patients who underwent total hip arthroplasty were divided into DVT group（n=31）and non-DVT group（n=82）according to whether they had DVT or not.Their clinical data and perioperative data were collected.At 24 hbefore surgery and at 24 h,72h,and 5dafter surgery,the serum levels of dsDNA/NETs were measured using PicoGreen fluorescent dye.The values of serum levels of dsDNA/NETs at different postoperative points in predicting lower extremity DVT after surgery were analyzed using the receiver operating characteristic（ROC）curve. Results The DVT group had significantly higher serum levels of dsDNA/NETs at 24 and 72hafter surgery than the non-DVT group（t=4.002,5.993;P〈0.05）.The serum levels of dsDNA/NETs in the two groups at 24 and 72hafter surgery were significantly higher than those at 24 hbefore surgery（F=27.023,43.575;P〈0.05）,while the serum levels of dsDNA/NETs in the two groups at 5dafter surgery showed no significant changes compared with those at 24 hbefore surgery（P〉0.05）.The ROC analysis showed that the area under the ROC curve（AUC）of the serum level of dsDNA/NETs at 24 hafter surgery for predicting DVT was 0.837（95% confidence interval（CI）=0.763-0.911）.When the dsDNA/NETs at 24 hafter surgery was0.46mg/L,the sensitivity and specificity for diagnosing DVT were 87.1% and 70.7%,respectively.The AUC of the serum level of dsDNA/NETs at 72 hafter surgery for predicting DVT was 0.647（95%CI=0.526-0.767）.When the dsDNA/NETs at 72 h after surgery was 0.39mg/L,the sensitivity and specificity for diagnosing DVT were 45.2% and 86.6%,respectively. Conclusion The serum levels of NETs in patients with lower extremity DVT after total hip arthroplasty increase,so it may be involved in the development of lower extremity DVT.It may be a potential biomarker for predicting and screeni

关 键 词：关节成形术 置换 髋 中性粒细胞胞外诱捕网 静脉血栓形成 

分 类 号：R687.42[医药卫生—骨科学]