Wang Chun-Yu, Zhang Jian-Li, Chen Zhi-Gang
Hebei North China Health Group Fengfeng General Hospital, Handan 056200, Hebei, China.
Hebei Provincial Corps Hospital of the Armed Police Force, Shijiazhuang 050081, Hebei, China.
Zhongguo Gu Shang. 2023 Nov 25;36(11):1085-90. doi: 10.12200/j.issn.1003-0034.2023.11.015.
To investigate the relationship between serum matrix metalloproteinase-1(MMP-1) and matrix metalloproteinase-2(MMP-2) and the formation of deep venous thrombosis(LDVT) in lower extremity patients after surgery for lower extremity fracture, and to analyze the value of MMP-1 and MMP-2 in predicting the occurrence of LDVT after lower extremity fracture.
From June 2018 to December 2021, 352 patients who planned to receive surgical treatment of lower limb fracture in our hospital were selected as the research objects. Venous blood was collected at 1, 2 and 3 days after surgery, respectively, and serum MMP-1 and MMP-2 levels were detected. The incidence of LDVT during hospitalization was analyzed, and the risk factors of postoperative LDVT in patients with lower limb fracture surgery and the predictive value of MMP-1 and MMP-2 for LDVT were analyzed.
LDVT occurred in 40 patients (LDVT group), the incidence of LDVT was 11.36%, and 312 patients did not occurred(no occurred group). The serum levels of MMP-1 and MMP-2 in LDVT group increased gradually after surgery; the serum levels of MMP-1 and MMP-2 in the no occurred group increased slightly after surgery at 2 days and then decreased at 3 days after surgery (<0.01);the serum levels of MMP-1 and MMP-2 in LDVT group were higher than those in the no occurred group at 2 days and 3 days after surgery (<0.05). Serum levels of MMP-1 and MMP-2 were positively correlated with serum levels of interleukin-6 (IL-6), IL-8 and tumor necrosis factor -α (TNF-α) in LDVT patients at 2 days and 3 days postoperatively (<0.05). Operative time, MMP-1 and MMP-2 postoperative 3 days were related to the occurrence of LDVT after lower limb fracture (<0.01). The area under the curve(AUC) predicted by MMP-1 and MMP-2 postoperative 3 days for LDVT after lower limb fracture was 0.738 and 0.744 respectively, and the AUC predicted by combined MMP-1 and MMP-2 was 0.910, which was higher than that predicted by single indicator(Z=2.819 and 2.025, <0.05).
High levels of MMP-1 and MMP-2 after lower extremity fracture are closely related to the occurrence of LDVT, and 3 d mMP-1 and MMP-2 after surgery maybe used as evaluation indexes for LDVT risk prediction.
探讨血清基质金属蛋白酶-1（MMP-1）和基质金属蛋白酶-2（MMP-2）与下肢骨折术后患者下肢深静脉血栓形成（LDVT）的关系，并分析MMP-1和MMP-2在预测下肢骨折后LDVT发生中的价值。
选取2018年6月至2021年12月在我院拟行下肢骨折手术治疗的352例患者作为研究对象。分别于术后1、2、3天采集静脉血，检测血清MMP-1和MMP-2水平。分析住院期间LDVT的发生率，分析下肢骨折手术患者术后LDVT的危险因素以及MMP-1和MMP-2对LDVT的预测价值。
40例患者发生LDVT（LDVT组），LDVT发生率为11.36%，312例未发生（未发生组）。LDVT组术后血清MMP-1和MMP-2水平逐渐升高；未发生组术后2天血清MMP-1和MMP-2水平略有升高，术后3天下降（<0.01）；术后2天和3天LDVT组血清MMP-1和MMP-2水平高于未发生组（<0.05）。术后2天和3天LDVT患者血清MMP-1和MMP-2水平与白细胞介素-6（IL-6）、IL-8和肿瘤坏死因子-α（TNF-α）水平呈正相关（<0.05）。手术时间、术后3天的MMP-1和MMP-2与下肢骨折后LDVT的发生有关（<0.01）。术后3天MMP-1和MMP-2预测下肢骨折后LDVT的曲线下面积（AUC）分别为0.738和0.744，MMP-1和MMP-2联合预测的AUC为0.910，高于单一指标预测值（Z=2.819和2.025，<0.05）。
下肢骨折后MMP-1和MMP-2高水平与LDVT的发生密切相关，术后3天的MMP-1和MMP-2可作为LDVT风险预测的评估指标。
