全关节置换术患者组织因子、凝血酶激活纤溶抑制物、纤维蛋白原的分析

The analysis of tissue factor,thrombin-activatable fibrinolysis inhibitor and fibrinogen in total joint arthroplasty

目的通过分析髋关节成形术(TJA)患者组织因子(TF)、微粒组织因子(MP-TF)、凝血酶激活纤溶抑制物(TAFI)和纤维蛋白原水平(FIB),预测TJA患者潜在的出血风险。方法共60例TJA患者(TJA组)和10例健康人(对照组)纳入本研究。分别于术前和术后1d采集TJA患者血液样品。采用酶联免疫吸附反应(ELISA)方法测定研究对象TAFI、TF和MP-TF水平;采用Stago STA-R全自动立式血凝分析仪检测FIB水平。结果与对照组比较,术前和术后TF和MP-TF水平差异均有统计学意义。术前和术后组的TF水平均都较对照组低。与对照组相比,TJA组MP-TF水平术前和术后组水平均升高。TJA术前和术后FIB与对照组相比差异有统计学意义(P <0.05)。结论患者在接受TJA治疗前、后存在纤维蛋白溶解系统改变。并且手术能加剧这种变化。

Objective Tissue factor(TF),microparticle-tissue factor(MP-TF),thrombin-activatable fibrinolysis inhibitor(TAFI)and fibrinogen(FIB)levels in patients undergoing TJA were analyzed to predict the potential bleeding risk of TJA patients.Methods Blood samples were collected before and one day after total joint arthroplasty(TJA).60 patients and 10 healthy people enrolled in the study.Plasma samples were analyzed using enzyme-linked immunosorbent assay(ELISA)kits for TAFI,TF,and MP-TF;FIB level was measured by Stago STA-R automatic vertical hemagglutination analyzer.Results Compared with the control group,there were significant change of TF and MP-TF levels in the pre-operative and postoperative patients.TF levels in the pre-operative and postoperative patients were lower than that in the control group.Compared with the control group,the level of MP-TF in TJA group increased both before and after operation.Compared with healthy controls,there were significant change of FIB levels in the pre-operative and postoperative patients.Conclusion The results of this study confirm that patients undergoing TJA have preexisting alterations in the fibrinolytic system.Surgical intervention tended to exacerbate these changes.