静脉血浆中血栓调节蛋白、凝血酶-抗凝血酶复合物、组织型纤溶酶原激活剂-抑制物复合物、纤溶酶-抗纤溶酶复合物水平联合Caprini评分预测剖宫产术后下肢深静脉血栓形成风险  

Predictive value of TM,TAT,t-PAIC and PIC in venous plasma combined with Caprini score for the risk of deep vein thrombosis after cesarean section

作　　者：沈劼 蔡俊杰 朱蓓雯 SHEN Jie;CAI Junjie;ZHU Beiwen(Department of Laboratory Medicine,the First Maternal and Child Health Hospital Affiliated to Tongji University,Shanghai 200092,China)

机构地区：[1]同济大学附属第一妇婴保健院检验科,上海200092

出　　处：《中国性科学》2023年第3期75-79,共5页Chinese Journal of Human Sexuality

基　　金：上海市科学技术委员会科研计划项目(18401902511)。

摘　　要：目的探讨静脉血浆中血栓调节蛋白(TM)、凝血酶-抗凝血酶复合物(TAT)、组织型纤溶酶原激活剂-抑制物复合物(t-PAIC)、纤溶酶-抗纤溶酶复合物(PIC)水平联合Caprini评分预测剖宫产术后下肢深静脉血栓(DVT)形成风险的价值。方法选取2019年5月至2021年12月在同济大学附属第一妇婴保健院行剖宫产术的98例产妇的病例资料进行回顾性分析,根据术后是否发生DVT分为DVT组(n=28)和非DVT组(n=70)。分析比较两组产妇病例资料,采用Logistic回归分析影响剖宫产术后DVT形成的危险因素。比较两组术后3d静脉血浆中TM、TAT、t-PAIC、PIC水平及Caprini评分,并采用受试者工作特征(ROC)曲线评估各项指标单独检测及联合检测对剖宫产术后DVT风险的预测价值。结果Logistic回归分析显示,体重指数(BMI)≥28kg/m^(2)、合并糖尿病、长期口服避孕药均为影响剖宫产术后DVT的独立危险因素(OR=2.672、2.164、2.910,P<0.05)。DVT组TM、TAT、t-PAIC、PIC水平及Caprini评分均高于非DVT组(P<0.05)。ROC曲线结果显示,Caprini评分联合静脉血浆TM、TAT、t-PAIC、PIC检测对术后DVT具有较高的预测价值(P<0.05)。结论Caprini评分与静脉血浆TM、TAT、t-PAIC、PIC水平对剖宫产术后DVT形成风险有较好的预测价值,临床可根据产妇体征表现结合上述指标制定综合预防方案。Objective To explore the predictive value of thrombomodulin(TM),thrombin-antithrombin complex(TAT),tissue plasminogen activator-inhibitor complex(t-PAIC)and plasmin-ɑ2-plasmin inhibitor complex(PIC)in venous plasma combined with Caprini score for the risk of deep vein thrombosis(DVT)after cesarean section.Methods A retrospective analysis was performed on the case data of 98 puerperae undergoing cesarean section in the First Maternal and Child Health Hospital Affiliated to Tongji University between May 2019 and December 2021.According to presence or absence of postoperative DVT,they were divided into DVT group(n=28)and non-DVT group(n=70).The medical records of puerperae in the two groups were analyzed and compared.The risk factors of DVT after cesarean section were analyzed by Logistic regression analysis.The levels of TM,TAT,t-PAIC and PIC in venous plasma,and Caprini score were compared between the two groups at 3d after surgery.The predictive value of the above indexes alone and combined detection for DVT after cesarean section was evaluated by receiver operating characteristic(ROC)curves.Results Logistic regression analysis showed that body mass index(BMI)≥28kg/m^(2),diabetes mellitus and long-term oral contraceptives were independent risk factors of DVT after cesarean section(OR=2.672,2.164,2.910,P<0.05).The levels of TM,TAT,t-PAIC and PIC,and Caprini score in DVT group were higher than those in non-DVT group(P<0.05).The results of ROC curve analysis showed that Caprini score combined with TM,TAT,t-PAIC and PIC was of high predictive value for postoperative DVT(P<0.05).Conclusions Caprini score and levels of TM,TAT,t-PAIC and PIC in venous plasma have good predictive value for DVT risk after cesarean section.Clinically,comprehensive preventive programs can be formulated according to signs of puerperae and the above indexes.

关 键 词：剖宫产 下肢深静脉血栓 血栓分子标志物 Caprini评分 预测价值 

分 类 号：R714[医药卫生—妇产科学]