四肢创伤患者血清PAI-1、TF、ATⅢ水平变化及临床意义

Clinical significance of serum PAI-1,TF and AT Ⅲ levels in patients with limb trauma

目的探讨四肢创伤患者血清纤维蛋白溶解酶原激活物抑制剂-1(PAI-1)、血清组织因子(TF)、血清抗凝血酶Ⅲ(ATⅢ)水平变化及临床意义。方法选取2016年2月至2019年1月陕西省渭南市骨科医院收治的四肢创伤患者75例作为研究对象,依据创伤严重程度评分情况将所有患者分为轻度创伤组(41例)和重度创伤组(34例);另选取同期陕西省渭南市骨科医院健康体检者30例作为对照组。比较观察组与对照组在不同时间点血清PAI-1、TF及ATⅢ水平差异情况。结果与对照组比较,轻度创伤组及重度创伤组在伤后1、4、7d血清PAI-1水平均明显升高,差异均有统计学意义(P<0.05);重度创伤组在伤后1dPAI-1水平明显高于轻度创伤组,差异有统计学意义(P<0.05),而伤后4、7dPAI-1水平与轻度创伤组比较,差异均无统计学意义(P>0.05)。与对照组比较,轻度创伤组及重度创伤组血清TF水平在伤后1、4、7d均明显升高,差异均有统计学意义(P<0.05);重度创伤组伤后1、4、7d血清TF水平均明显高于轻度创伤组,差异均有统计学意义(P<0.05)。与对照组比较,轻度创伤组及重度创伤组血清ATⅢ水平伤后1、4、7d均明显降低,差异均有统计学意义(P<0.05);重度创伤组伤后1、4、7d血清ATⅢ水平明显低于轻度创伤组,差异均有统计学意义(P<0.05)。结论监测血清PAI-1、TF及ATⅢ水平变化,有助于临床对四肢创伤患者病情发展及预后进行评估。

Objective To investigate the changes and clinical significance of serum fibrinolytic activator inhibitor-1(PAI-1),tissue factor(TF)and antithrombinⅢ (ATⅢ)levels in patients with limb trauma.Methods A total of 75 patients with limb trauma admitted to Orthopedic Hospital of Weinan from February 2016 to January 2019 were divided into mild trauma group and severe trauma group according to the severity of trauma score.At the same time,30 people who came to our hospital for health examination during the same period were selected as the control group.AT Ⅲ,PAI-1 and TF at different time points were compared between the groups.Results Compared with the control group,the level of PAI-1 in the serum of the mild trauma group and the severe trauma group increased significantly on the 1 st,4 th,7 th day after injury(P<0.05).The level of PAI-1 in the severe trauma group was significantly higher than that in the mild trauma group(P<0.05),and there was no significant difference on the level of PAI-1 between the mild trauma group and the severe trauma group on the 4 th and 7 th day after injury(P>0.05).The levels of TF in 1 st,4 th and 7 th day in severe trauma group and mild trauma group were significantly increased(P<0.05).The levels of serum TF in 1 st,4 th and 7 th day after injury of severe trauma group were significantly higher than those in mild trauma group(P<0.05).The levels of serum ATⅢin mild trauma group and severe trauma group were significantly decreased(P<0.05),and the levels of serum ATⅢin severe trauma group were significantly lower than those in mild trauma group(P<0.05).Conclusion The levels of PAI-1,TF and ATⅢin patients with limb trauma has changed.Monitoring the changes of serum PAI-1,TF and ATⅢlevels could help to evaluate the development and prognosis of patients with limb trauma.