血小板CD36与膝关节置换术后发生急性肺栓塞的相关因素

The association between platelet CD36 expression and risk of acute pulmonary embolism in patients undergoing total knee arthroplasty surgery

目的探讨血小板CD36的表达与行全膝关节置换术（TKA）患者术后发生急性肺栓塞（APE）的关系。方法选取50例TKA术后发生APE患者和同期150例TKA术后未发生APE和血栓患者进行基本资料比较。结果两组患者年龄、抗凝剂使用、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）以及D-二聚体（D-D）比较差异均有统计学意义（P〈0.05）。血小板CD36在APE患者中明显高表达,差异有统计学意义（P〈0.05）。在Logistic回归分析中,年龄、抗凝剂的使用、D-D以及血小板CD36的异常表达与APE发生密切相关。ROC曲线分析结果显示,血小板CD36的高表达在对于TKA术后发生APE具有较好的诊断价值,曲线下面积为0.821（95%CI 0.749-0.892,P〈0.001）,敏感性为81.6%,特异性为71.5%。结论血小板CD36在TKA术后发生APE的患者中升高,CD36在血小板的异常表达是TKA患者发生APE的危险因素。TKA后行血小板CD36检测对于预防APE发生有一定临床意义。

Objective To study the association between platelet CD36 and acute pulmonary embolism（ APE） in patients after total knee arthroplasty（ TKA）. Methods A total of 50 patients with APE and 150 non-APE patients simuleaneously were included,and baseline data were compared in this study. Results Age,anticoagulant use,total cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein cholesterin（ LDL-C） and D dimer（ D-D） in patients with APE had statistical differences compared with non-APE patients（ P〈0. 05）,and the platelet CD36 expression in patients with APE was higher than non-APE patients（ P〈0. 05）. In Logistic regression analysis,age,anticoagulants use,D-D and platelet CD36 were close associated with APE. ROC curve analysis results showed that higher platelet CD36 expression had well diagnostic value for APE with patients of the area under the curve of 0. 821（ 95% CI： 0. 749 - 0. 892,P〈0. 001）,the sensitivity and specificity was 81. 6% and 71. 5%,respectively. Conclusions The expression of platelet CD36 is high in APE patients,and higher CD36 expression in platelet is risk factors of APE after undergoing TKA,platelet CD36 has certain clinical value for preventing APE after TKA.