人工关节置换与深静脉血栓的生物标志物

Biomarkers of deep venous thrombosis after total joint arthroplasty

背景:深静脉血栓是人工关节置换的常见及严重并发症,在临床上超声及静脉造影被广泛应用于深静脉血栓的诊断,但是他们各有缺点。目的:寻找一种更加合适无创的早期诊断深静脉血栓的生物标记物。方法:以"Thrombosis,DVT,Biomarke,rTotal Joint Arthroplasty,D-dimer,FactorⅧ,Thrombin Generation Fibrin Monomer,P-selectin,Inflammatory Cytokines,Microparticles,Leukocyte Count,Genetic factors,Micro RNAs"为检索词,应用计算机在PubM ed数据库检索1995年1月至2015年3月的相关文献,并进行筛选、归纳和总结。结果与结论:共纳入66篇符合标准文献。将诊断深静脉血栓的生物标志物分为凝血相关标志物、炎性标志物及基于分子生物学及遗传学三大层面,并阐述其在诊断治疗中的机制与作用,以求寻找经济、安全、临床可以广泛应用且准确度和敏感度更佳的生物标志物,为早期预测诊断深静脉血栓提供理论基础。

BACKGROUND： Deep venous thrombosis is one of the common and fatal complications of total joint arthroplasty For our clinical practice, we require duplex ultrasound and venography to evaluate the presence of deep venous thrombosis, but the diagnostic tools have several disadvantages. OBJECTIVE： To explore the appropriate and non-invasive biomarkers in the early diagnosis of deep venous thrombosis. METHODS： With the key words of ＂Thrombosis, DVT, Biomarker, Total Joint Arthroplasty, D-dimer, Factor VIII, Thrombin Generation, Fibrin Monomer, P-selectin, Inflammatory Cytokines, Microparticles, Leukocyte Count, Genetic factors, MicroRNAs＂, a computer-based search was performed for articles published in PubMed database from January 1995 to March 2015. After the initial screening, the reserved articles were further detailed, summarized and concluded. RESULTS AND CONCLUSION： Totally 66 articles were collected. This brief review is used to analyze the mechanism of the biomarkers which are classified into three levels as follow： detection of blood coagulation, inflammation markers and molecular biology and genetics-based biomarkers. The review also showed a great need of economic and safer biomarkers for the clinic and provided the theoretical basis to diagnose and predict deep venous thrombosis in an early stage.