Du Ya-Qing, Tang Ju, Zhang Zhen-Xiang, Bian Jian
Department of Orthopedics, the Affiliated Taizhou People's Hospital of Nantong University, Taizhou, Jiangsu Province, P. R. China.
Department of Orthopedics, the Affiliated Taizhou People's Hospital of Nantong University, Taizhou, Jiangsu Province, P. R. China.
Ann Vasc Surg. 2019 Jan;54:282-289. doi: 10.1016/j.avsg.2018.06.013. Epub 2018 Aug 10.
In the present study, we aimed to inspect the correlation of interleukin-18 (IL-18) and high-sensitivity C-reactive protein (hs-CRP), if any present, with the occurrence of perioperative deep vein thrombosis (DVT) in patients suffering from an ankle fracture (AF).
Sixty-seven AF patients with complicated DVT (DVT group) and 448 AF patients without DVT (non-DVT group) were enrolled in the present study. To begin with, hemorheological indexes were detected. Turbidimetric immunoassay and enzyme-linked immunosorbent assay were used for the determination of the expressions of hs-CRP and IL-18, respectively. Coagulation method was used to detect prothrombin time (PT), thrombin time (TT), fibrinogen, and activated partial thromboplastin time (APTT). Logistic regression analysis was used to analyze the independent risk factors for DVT occurrence in AF patients after operation.
The results revealed that the DVT group presented an increased expression of hs-CRP and IL-18 1 day before operation and 1, 3, and 7 days after operation in comparison with the non-DVT group. The DVT group also had increased levels of PT, APTT, and prolonged TT and fibrinogen at 3 and 7 days after operation compared to the non-DVT group. After operation, it was observed that the patients in the DVT group had increased plasma viscosity, whole blood reduced viscosity, red blood cell (RBC) aggregation index, RBC deformation index, erythrocyte sedimentation rate, and declined erythrocrit. The independent risk factors for the occurrence of DVT were identified to be high-energy injury, TT, fibrinogen, hs-CRP, and IL-18 in AF patients after operation.
Based on the results obtained from the study, it was concluded that AF patients with DVT have higher levels of IL-18 and hs-CRP expressions, which is associated with the occurrence and development of DVT. These results may be particularly useful for diagnosis and treatment on DVT occurrence in AF patients.
在本研究中，我们旨在探讨白细胞介素-18（IL-18）和高敏C反应蛋白（hs-CRP）（若存在）与踝关节骨折（AF）患者围手术期深静脉血栓形成（DVT）发生之间的相关性。
本研究纳入了67例合并DVT的AF患者（DVT组）和448例无DVT的AF患者（非DVT组）。首先，检测血液流变学指标。分别采用比浊免疫分析法和酶联免疫吸附测定法测定hs-CRP和IL-18的表达。采用凝固法检测凝血酶原时间（PT）、凝血酶时间（TT）、纤维蛋白原和活化部分凝血活酶时间（APTT）。采用Logistic回归分析分析AF患者术后发生DVT的独立危险因素。
结果显示，与非DVT组相比，DVT组在术前1天以及术后1、3和7天hs-CRP和IL-18表达增加。与非DVT组相比，DVT组在术后3天和7天PT、APTT水平升高，TT延长，纤维蛋白原增加。术后观察到，DVT组患者血浆黏度、全血还原黏度、红细胞（RBC）聚集指数、RBC变形指数、红细胞沉降率升高，红细胞压积下降。AF患者术后发生DVT的独立危险因素为高能损伤、TT、纤维蛋白原、hs-CRP和IL-18。
基于本研究结果，得出结论：合并DVT的AF患者IL-18和hs-CRP表达水平较高，这与DVT的发生和发展有关。这些结果可能对AF患者DVT发生的诊断和治疗特别有用。
