Jørgensen L N, Lind B, Hauch O, Leffers A, Albrecht-Beste E, Konradsen L A
Department of Orthopedic Surgery, Central Hospital, Hillerød, Denmark.
Thromb Res. 1990 Jul 1;59(1):69-76. doi: 10.1016/0049-3848(90)90272-e.
Thrombin-antithrombin-III complexes (TAT) & D-dimer in plasma, and fibrin(ogen) degradation products (FDP) in serum, were measured in 48 patients subjected to total hip arthroplasty. Blood samples were collected on days -1, 0, 1, 3, 7 and 10. Five patients developed postoperative deep vein thrombosis (DVT) diagnosed by venography. A characteristic pattern of TAT and D-dimer secondary to surgery was demonstrated. A poor correlation was found between ELISA- and latex-D-dimer concentrations after the operation. Patients with DVT had significantly higher TAT-levels preoperatively, and on day 0, 7 and 10. The concentration of FDP was significantly elevated in patients with DVT on day 7 and that of ELISA D-dimer on days 0 & 10. None of the assays are clinically valuable for purposes of postoperative screening for DVT. The preoperative plasma TAT concentration may represent a valuable predictive marker of postoperative DVT.
对48例行全髋关节置换术的患者测定了血浆中的凝血酶 - 抗凝血酶III复合物（TAT）和D - 二聚体，以及血清中的纤维蛋白（原）降解产物（FDP）。在术前第1天、手术日（第0天）、术后第1天、3天、7天和10天采集血样。5例患者经静脉造影诊断为术后深静脉血栓形成（DVT）。显示出手术继发的TAT和D - 二聚体的特征性模式。术后ELISA法和乳胶法检测的D - 二聚体浓度之间相关性较差。DVT患者术前以及术后第0天、7天和10天的TAT水平显著更高。DVT患者在术后第7天FDP浓度显著升高，在术后第0天和10天ELISA法检测的D - 二聚体浓度显著升高。这些检测方法均对术后DVT筛查无临床价值。术前血浆TAT浓度可能是术后DVT的一个有价值的预测指标。
