Department of Anesthesiology and Perioperative Intensive Care, University Medical Centre Ljubljana, Slovenia.
Department of Vascular Disease, University Medical Centre Ljubljana, Slovenia.
Clin Appl Thromb Hemost. 2021 Jan-Dec;27:1076029620985941. doi: 10.1177/1076029620985941.
Our study aimed to investigate the levels and time-course of systemic inflammatory and hemostasis markers in the early postoperative period in patients undergoing total hip replacement (THR). The study included 70 patients of both sexes, average age 68.4 ± 10.9 years. Levels of inflammatory and hemostasis markers were measured before surgery (POD 0), a day after the surgery (POD 1) and 5 days after surgery (POD 5). In the postoperative period inflammatory markers increased. The operation provoked a significant increase of CRP on POD 1 in comparison to POD 0 (68.5 ± 5.4 vs 6.8 ± 2.2 μg/mL, p < 0.001) and the additional increase was registered on POD 5 (87.5 ± 8.1 vs 68.5 ± 5.4 μg/mL, p < 0.001). Interleukin-6 significantly increased on POD 1 (251.5 ± 21.6 vs 14.6 ± 7.1 μg/mL, p < 0.001) and after that (POD 5) decreased. After surgery leukocyte count, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were significantly higher compared to POD 0. Activation of coagulation in the postoperative period was shown by increased peak thrombin on POD 5 in comparison to POD 0 (185 ± 27 vs. 124 ± 31 nM, p < 0.001). D-dimer was increased on POD 1 and an additional rise was observed on POD 5. vWF also progressively increased in the observed period. Results of our study showed that after THR systemic inflammatory markers increased and coagulation function was enhanced. Determination of inflammatory and procoagulant markers could help identify patients at risk for cardiovascular thromboembolic events.
我们的研究旨在探讨全髋关节置换术（THR）后早期患者全身炎症和止血标志物的水平和时间过程。该研究纳入了 70 名男女患者，平均年龄为 68.4±10.9 岁。在手术前（术后第 0 天，POD0）、手术后第 1 天（POD1）和第 5 天（POD5）测量炎症和止血标志物的水平。在术后期间，炎症标志物增加。手术引起 CRP 在 POD1 时显著升高，与 POD0 相比（68.5±5.4 对 6.8±2.2μg/ml，p<0.001），并在 POD5 时进一步升高（87.5±8.1 对 68.5±5.4μg/ml，p<0.001）。白细胞介素-6 在 POD1 时显著升高（251.5±21.6 对 14.6±7.1μg/ml，p<0.001），之后（POD5）下降。手术后，白细胞计数、中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值与 POD0 相比明显升高。术后凝血激活表现为 POD5 时最大凝血酶增加，与 POD0 相比（185±27 对 124±31 nM，p<0.001）。D-二聚体在 POD1 时升高，在 POD5 时观察到进一步升高。vWF 在观察期内也逐渐增加。我们的研究结果表明，THR 后全身炎症标志物增加，凝血功能增强。炎症和促凝标志物的测定有助于识别发生心血管血栓栓塞事件的风险患者。
