Department of Clinical Laboratory, Peking University Fourth School of Clinical Medicine, Beijing, China.
Department of Clinical Laboratory, 66526Beijing Jishuitan Hospital, Beijing, China.
Clin Appl Thromb Hemost. 2023 Jan-Dec;29:10760296231153400. doi: 10.1177/10760296231153400.
Venous thromboembolism is a common complication following trauma. We investigated the dynamics of plasma microparticles (MPs) levels and explored their potential as biomarkers of deep vein thromboembolism (DVT) after trauma. A total of 775 patients with traumatic fractures were recruited in this nested study. About 106 trauma patients (53 DVT subjects and 53 age-, sex-, and fracture site-matched non-DVT subjects) and 53 healthy volunteers met the enrollment criteria. MPs were characterized by transmission electron microscope, nanoparticle tracking analysis, and western blotting. Circulating levels of MPs were measured using a flow cytometer. Meanwhile, routine laboratory parameters were examined in all patients. Compared to non-DVT patients, DVT patients had higher circulating phosphatidylserine (PS) + MPs, hepatocyte-derived MPs (HMPs), PS + HMPs, and platelet-derived MPs (PMPs). Notably, PS + HMPs had the best predictive value for DVT diagnosis in trauma patients (area under the curve [AUC] 0.8939, 95% CI 0.8326 to 0.9552), which was superior to d-dimer (AUC 0.5881). The Hepatic Procoagulant Index combined plasma levels of PS + HMPs and albumin, increasing the AUC to 0.8978 (95% CI 0.8396 to 0.9561). This is the first study that addressed circulating PS + HMPs are promising biomarkers with high performance in diagnosing DVT. The Hepatic Procoagulant Index is a potential predictor of DVT in trauma patients.
静脉血栓栓塞是创伤后的常见并发症。我们研究了血浆微粒（MPs）水平的动态变化，并探讨了它们作为创伤后深静脉血栓形成（DVT）生物标志物的潜力。本巢式研究共纳入了 775 例创伤性骨折患者。大约 106 例创伤患者（53 例 DVT 患者和 53 例年龄、性别和骨折部位匹配的非 DVT 患者）和 53 例健康志愿者符合入组标准。通过透射电子显微镜、纳米颗粒跟踪分析和 Western blot 对 MPs 进行了表征。使用流式细胞仪测量循环 MPs 水平。同时，对所有患者进行了常规实验室参数检查。与非 DVT 患者相比，DVT 患者的循环磷脂酰丝氨酸（PS）+ MPs、肝细胞来源的 MPs（HMPs）、PS+HMPs 和血小板来源的 MPs（PMPs）水平更高。值得注意的是，PS+HMPs 对创伤患者 DVT 诊断具有最佳预测价值（曲线下面积 [AUC] 0.8939，95%置信区间 0.8326 至 0.9552），优于 D-二聚体（AUC 0.5881）。肝促凝血酶原激酶指数结合 PS+HMPs 和白蛋白的血浆水平，将 AUC 提高至 0.8978（95%置信区间 0.8396 至 0.9561）。这是第一项研究表明循环 PS+HMPs 是具有高诊断性能的 DVT 有前途的生物标志物。肝促凝血酶原激酶指数是创伤患者 DVT 的潜在预测因子。
