Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, Guangdong, China.
Department of Orthopedics, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518000, Guangdong, China.
BMC Musculoskelet Disord. 2022 Jun 14;23(1):574. doi: 10.1186/s12891-022-05532-1.
Early predictive markers of venous thromboembolism (VTE) after total hip arthroplasty (THA)/total knee arthroplasty (TKA) remain unclear. Our study identified early predictive markers for VTE after THA/TKA.
A single-institution retrospective review study was conducted between May 2020 and April 2022 (n = 256). All patients underwent Doppler ultrasounds exam in preoperation and seventh day after surgery. Deep vein thrombosis (DVT) was defined by Doppler ultrasound of the lower extremities, which revealed thrombosis. Thrombin-antithrombin complex (TAT), thrombomodulin (TM), and plasmin-antiplasmin complex (PIC) concentration were tested from each patient's preoperative and postoperative days 1, 4, 7, 14. These values were then accessed via receiver operating characteristic (ROC) curve analysis and further quantified the level of this risk by concentration.
On postoperative day 1 (pod-1), all patients' TAT and PIC concentrations were significantly higher than those preoperatively (p < 0.05). The levels of TAT and PIC in patients in the DVT group on pod-1 were significantly higher than those in the non-DVT group (p < 0.05). At pod-1, the TAT concentration for DVT patients was 49.47 ng/mL compared to 20.70 ng/mL for non-DVT patients, PIC was 3.72μg/mL compared to 1.65μg/mL. ROC curve analysis demonstrated that a TAT concentration of 24.3 ng/mL had a sensitivity of 87.9% and a specificity of 69.1%.
TAT levels on pod-1 may predict DVT early after THA/TKA, which makes it possible for early intervention to decrease the incidence of DVT.
全髋关节置换术（THA）/全膝关节置换术（TKA）后静脉血栓栓塞症（VTE）的早期预测标志物仍不清楚。本研究旨在确定 THA/TKA 后 VTE 的早期预测标志物。
这是一项 2020 年 5 月至 2022 年 4 月在单机构进行的回顾性研究（n=256）。所有患者在术前和术后第 7 天均接受了下肢多普勒超声检查。下肢深静脉血栓形成（DVT）通过下肢多普勒超声检查发现血栓来定义。在术前和术后第 1、4、7、14 天，检测每位患者的凝血酶-抗凝血酶复合物（TAT）、血栓调节蛋白（TM）和纤溶酶-抗纤溶酶复合物（PIC）浓度。然后通过接收者操作特征（ROC）曲线分析评估这些值，并通过浓度进一步量化这种风险的水平。
术后第 1 天（pod-1），所有患者的 TAT 和 PIC 浓度均明显高于术前（p<0.05）。DVT 组患者在 pod-1 的 TAT 和 PIC 水平明显高于非 DVT 组（p<0.05）。在 pod-1，DVT 患者的 TAT 浓度为 49.47ng/mL，而非 DVT 患者为 20.70ng/mL，PIC 浓度分别为 3.72μg/mL 和 1.65μg/mL。ROC 曲线分析表明，TAT 浓度为 24.3ng/mL 时，其敏感性为 87.9%，特异性为 69.1%。
THA/TKA 后 pod-1 的 TAT 水平可能早期预测 DVT，这使得早期干预降低 DVT 的发生率成为可能。
