Evaluation for endogenous anticoagulation potential of bone fracture patients with deep venous thrombosis formation / 临床检验杂志

ABSTRACT

Objective To evaluate the endogenous anticoagulation potential of bone fracture patients and its relationship with deep venous thrombosis formation (DVT).Methods A total of 95 DVT patients after bone fracture and 100 healthy subjects as control from Beijing Jishuitan Hospital were included in this study.On the third day after orthopedic surgery,the citrated anticoagulant plasma samples were collected and fibrin degradation products (FDP) and D-dimer (DD) were measured.Protac-induced coagulation inhibition percentage (PICI) was measured with ThromboPath (ThP) chromogenic assay as the marker of endogenous anticoagulation potential.The serum samples from patients were collected to measure the concentration of high-density lipoprotein cholesterol (HDL-C).Results Both FDP and DD values of DVT patient group were significantly higher than those of healthy control group (all P ＜ 0.01).The PICI (％) of DVT patients group was significantly lower than that of healthy control group (82.8 ± 7.2 vs 87.8 ± 3.6,P ＜ 0.01).The PICI of patients ≥65 years old was 4.8 percent lower than that of the patients ＜65 years old (P ＜0.05) in DVT group.When the cut-off value for PICI was set as 84.2％,a significant difference was showed between DVT and control group by Chi-Square test (P ＜0.0 1).PICI was negatively correlated with FDP and DD (r =-0.318,-0.336,both P ＜ 0.01),but positively correlated with HDLC (r =0.284,P ＜ 0.01).Logistic regression analysis suggested that PICI was a risk factor of DVT with odds ratio 1.243 (P ＜ 0.01).Conclusion The endogenous anticoagulation potential may be severely impaired in DVT patient after bone fracture.