凝血因子Ⅷ/Ⅺ/ⅩⅢ多态性与人工关节置换术后凝血因子活性和深静脉血栓形成的相关性分析

Correlation between coagulation factorⅧ/Ⅺ/ⅩⅢpolymorphism and clotting factor activity and deep vein thrombosis after artificial joint replacement

目的探究凝血因子Ⅷ/Ⅺ/ⅩⅢ多态性与人工关节置换术后凝血因子活性及深静脉血栓形成的相关性。方法筛选100名健康志愿者和200例人工置换术后患者分别设为对照组和手术组,对FⅩⅢ/Val34Leu和FⅩⅢ/Pro564Leu基因型、突变率以及凝血因子Ⅷ/Ⅺ/ⅩⅢ活性进行检测,利用Logistic回归分析法对凝血因子Ⅷ/Ⅺ/ⅩⅢ多态性与人工关节置换术后凝血因子活性及深静脉血栓形成的相关性进行分析。结果手术组凝血因子Ⅷ/Ⅺ/ⅩⅢ活性较对照组均有所增强(P<0.05);手术组的凝血酶原时间、凝血酶时间、活化部分凝血活酶时间水平较对照组缩短(P<0.05),同时手术组的蛋白C含量上调(P<0.05),蛋白S含量、皮温和静脉血流速度下降(P<0.05)。Logistic回归分析结果表明,凝血因子Ⅷ/Ⅺ/ⅩⅢ是受试者术后凝血因子活性和深静脉血栓形成的影响因素。结论凝血因子Ⅷ/Ⅺ/ⅩⅢ多态性是人工关节置换术后凝血因子活性和深静脉血栓形成的影响因素,且具有正相关性。

Objective To explore the correlation between coagulation factorⅧ/Ⅺ/ⅩⅢpolymorphism and coagulation factor activity and deep vein thrombosis after artificial joint replacement.Methods 100 healthy volunteers and 200 patients after artificial joint replacement were set as the control group and the operation group.We detected the FⅩⅢ/Val34Leu and FⅩⅢ/Pro564Leu genotypes and their mutation rates as well as the activity of coagulation factorⅧ/Ⅺ/ⅩⅢ.Logistic regression analysis was used to analyze the correlation between coagulation factorⅧ/Ⅺ/ⅩⅢpolymorphism and coagulation factor activity and deep vein thrombosis after artificial joint replacement.Results The activity of coagulation factorⅧ/Ⅺ/ⅩⅢin the operation group was significantly higher than that in the control group(P<0.05).The prothrombin time,thrombin time and activated partial thromboplastin time in the operation group were shorter than those in the control group(P<0.05),while the protein C content in the operation group was increased(P<0.05),and the protein S content,skin temperature and vein blood flow velocity decreased(P<0.05).Logistic regression analysis showed that clotting factorⅧ/Ⅺ/ⅩⅢ was the influencing factor of postoperative clotting factor activity and deep vein thrombosis.Conclusion The coagulation factorⅧ/Ⅺ/ⅩⅢ polymorphism is the influencing factor of coagulation factor activity and deep vein thrombosis after artificial joint replacement,and has a positive correlation.