血栓标志物联合凝血6项对老年急性血栓性疾病患者凝血功能的评价作用  

Evaluation of thrombotic markers combined with 6 coagulation items on coagulation function in acute thrombotic diseases in the elderl

作　　者：任江涛 蔡玮 REN Jiangtao;CAI Wei(Department of Clinical Laboratory,Yangling Demonstration District Hospital,Xianyang,Shaanxi 712100,China)

机构地区：[1]杨凌示范区医院检验科,陕西咸阳712100

出　　处：《检验医学与临床》2023年第22期3360-3365,共6页Laboratory Medicine and Clinic

摘　　要：目的分析血栓标志物联合凝血6项对老年急性血栓性疾病患者凝血功能的评价作用。方法选取2019年5月至2021年4月该院收治的126例老年急性血栓性疾病患者作为研究组,选取同期在该院进行健康体检的老年人52例作为对照组。检测并比较两组血栓标志物[凝血酶-抗凝血酶复合物(TAT)、组织型纤溶酶原激活抑制复合物(t-PAIC)、凝血酶原片段1+2(F1+2)、血管性假性血友病因子(vWF)、抗胰蛋白酶(AT)、凝血VⅢ因子活性(FVⅢ)]、凝血6项指标[D-二聚体(D-D)、纤维蛋白原降解产物(FDP)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]水平;采用Pearson相关分析血栓标志物与凝血6项指标的相关性;采用多因素Logistic回归分析影响老年急性血栓性疾病患者预后的因素;采用受试者工作特征(ROC)曲线分析血栓标志物联合凝血6项指标预测老年急性血栓性疾病患者预后的临床价值。结果与对照组比较,研究组TAT、t-PAIC、F1+2、AT、vWF、FVⅢ、D-D、FDP、FIB水平均明显升高,APTT、TT、PT水平均明显降低,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,TAT、F1+2、vWF、FVⅢ与D-D、FDP、FIB呈明显正相关(P<0.05),与APTT、TT、PT呈明显负相关(P<0.05);t-PAIC与D-D、FIB呈明显正相关(P<0.05),与APTT、TT、PT呈明显负相关(P<0.05),而与FDP无明显相关(P>0.05);AT与D-D、FDP、FIB呈明显正相关(P<0.05),与APTT呈明显负相关(P<0.05),而与TT、PT无明显相关(P>0.05)。126例患者的随访数据完整(随访率为100%),其中随访期间发生不良心脏事件的37例患者纳入预后不良组,未发生不良心脏事件的89例患者纳入预后良好组。与预后良好组比较,预后不良组血栓标志物TAT、t-PAIC、F1+2、AT、vWF、FVⅢ水平及凝血6项中D-D、FDP、FIB水平均明显升高,APTT、TT、PT水平均明显降低,差异有统计学意义(P<0.05)。TAT≥6.52 ng/mL、t-PAIC�Objective To analyze the effect of thrombus markers combined with 6 coagulation items on the evaluation of coagulation function in elderly patients with acute thrombotic diseases.Methods A total of 126 elderly patients with acute thrombotic diseases who were treated in Yangling Demonstration District Hospital from May 2019 to April 2021 were selected as the study group,and 52 elderly patients who underwent health examination in this hospital during the same period were selected as the control group.Thrombotic markers[thrombin-antithrombin complex(TAT),tissue type plasminogen activation inhibition complex(t-PAIC),prothrombin fragment 1+2(F1+2),vascular false hemophilia factor(vWF),antitrypsin(AT),blood clotting factor activity(FVⅢ)]and 6 coagulation indicators[D-dimer(D-D),fibrinogen degradation product(FDP),fibrinogen(FIB),activated partial thromboplastin time(APTT),thrombin time(TT),prothrombin time(PT)]of the two groups were detected and compared.Pearson correlation was used to analyze the corre-lations between thrombotic markers and 6 coagulation indexes.Multivariate Logistic regression was used to analyze the factors affecting the prognosis of elderly patients with acute thrombotic diseases.Receiver operat-ing characteristic(ROC)curve was used to analyze the clinical value of thrombosis markers combined with 6 coagulation indexes in predicting prognosis of elderly patients with acute thrombotic diseases.Results Com-pared with the control group,TAT,t-PAIC,F1+2,AT,vWF,FVⅢ,D-D,FDP and FIB levels in the study group increased significantly,while APTT,TT and PT levels decreased significantly,with statistical signifi-cance(P<0.05).Pearson correlation analysis showed that TAT,F1+2,vWF and FⅢcorrelated positively with D-D,FDP and FIB(P<0.05),while correlated negatively with APTT,TT and PT(P<0.05).t-PAIC correlated positively with D-D and FIB(P<0.05),correlated negatively with APTT,TT and PT(P<0.05),but had no significant correlation with FDP(P>0.05).AT correlated positively with D-D,FDP and FIB(P<0.05),correlate

关 键 词：血栓标志物 凝血6项 老年 急性血栓性疾病 凝血功能 

分 类 号：R446.1[医药卫生—诊断学]