血清FM、TAT、MIP-1α与产后静脉血栓栓塞症的关系及其预测价值研究

Study on the Relationship between Serum FM, TAT, MIP-1α and Postpartum Venous Thromboembolism and its Predictive Value

目的:探讨血清纤维蛋白单体(FM)、凝血酶-抗凝血酶复合物(TAT)、巨噬细胞炎性蛋白-1α(MIP-1α)与产后静脉血栓栓塞症(VTE)的关系及其预测价值研究。方法:选取2021年12月-2023年12月在成都医学院第二附属医院分娩后有VTE的产妇纳入VTE组(n=45),根据1:4配对方法选择我院同期分娩后无VTE的产妇纳入非VTE组(n=180)。采用酶联免疫吸附法(ELISA)检测血清FM、TAT、MIP-1α、D-二聚体(D-D)水平。多因素Logistic回归分析产后发生VTE的影响因素,并绘制受试者工作特征(ROC)曲线分析血清FM、TAT、MIP-1α、D-D水平对产后VTE的预测价值。结果:与非VTE组比较,VTE组血清FM、TAT、MIP-1α、D-D水平升高(P<0.05)。多因素Logistic回归分析显示,年龄增加、剖宫产和FM、TAT、MIP-1α、D-D升高为影响产后VTE的独立危险因素(P<0.05)。ROC曲线分析显示,血清FM、TAT、MIP-1α、D-D水平联合预测产后VTE的曲线下面积为0.911,大于血清FM、TAT、MIP-1α、D-D水平单独预测的0.748、0.755、0.722、0.592。结论:血清FM、TAT、MIP-1α水平升高是产后VTE的独立危险因素,血清FM、TAT、MIP-1α联合D-D对产后VTE的预测价值较高。

Objective:To investigate the relationship between serum fibrin monomer(FM),thrombin-antithrombin complex(TAT),macrophage inflammatory protein-1α(MIP-1α)and postpartum venous thromboembolism(VTE)and its predictive value.Methods:Pregnant women with VTE after delivery in The Second Affiliated Hospital of Chengdu Medical College from December 2021 to December 2023 were included in VTE group(n=45),pregnant women without VTE after delivery in our hospital during the same period were included in non-VTE group(n=180)according to the 1:4 pairing method.Serum FM,TAT,MIP-1αand D-dimer(D-D)levels were detected by enzyme-linked immunosorbent assay(ELISA).The influencing factors of postpartum VTE were analyzed by multivariate Logistic regression analysis,and the predictive value of serum FM,TAT,MIP-1αand D-D levels for postpartum VTE were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with non-VTE group,the serum levels of FM,TAT,MIP-1αand D-D in VTE group were increased(P<0.05).Multivariate Logistic regression analysis showed that,increased age,uterine-incision delivery and increased FM,TAT,MIP-1α,and D-D were independent risk factors for postpartum VTE(P<0.05).ROC curve analysis showed that,the area under the curve of combined prediction of serum FM,TAT,MIP-1αand D-D levels for postpartum VTE was 0.911,which was greater than 0.748,0.755,0.722 and 0.592 predicted by serum FM,TAT,MIP-1αand D-D levels alone.Conclusion:The increase of serum FM,TAT and MIP-1αlevels are independent risk factors for postpartum VTE,serum FM,TAT,MIP-1αcombine with D-D has a high predictive value for postpartum VTE.