产后深静脉血栓患者血清CD40配体含量与凝血、血小板功能及炎症反应程度的相关性

Correlations between serum CD40L level and coagulation,platelet function,degree of inflammatory response in patients with postpartum deep vein thrombosis

目的观察深静脉血栓(DVT)患者血清CD40配体(CD40L)含量与凝血、血小板功能及炎症反应程度的相关性。方法选择2015年3月-2017年11月期间在该院分娩并发生产后深静脉血栓形成的产妇52例作为DVT组,同期在该院分娩的健康产妇80例作为对照组。测定外周血中CD40L、凝血指标、血小板功能参数及相关炎症细胞因子。结果 DVT组产妇外周血中CD40L、D-二聚体(D-D)、纤维蛋白原(FIB)、血小板活化因子(PAF)、P-选择素(P-selectin)、血管性血友病因子(v WF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6 (IL-6)、白细胞介素-10 (IL-10)及C-反应蛋白(CRP)均高于对照组,凝血酶原时间(PT)、部分活化凝血酶时间(APTT)均低于对照组(P <0. 05),且CD40L与APTT、PT呈负相关(r=-0. 592、-0. 614,P=0. 016、0. 013),与D-D、FIB、PAF、P-selectin、v WF、TNF-α、IL-10、CRP呈正相关(r=0. 531、0. 557、0. 657、0. 459、0. 573、0. 691、0. 496、0. 539, P=0. 022、0. 020、0. 008、0. 032、0. 018、0. 003、0. 030、0. 022)。结论产后深静脉血栓患者CD40L的增多能够促进凝血、血小板聚集及炎症反应活化。

Objective To research the correlations between serum CD40 L level and coagulation,platelet function,degree of inflammatory response in patients with deep vein thrombosis(DVT).Methods From March 2015 to November 2017,the women with DVT after delivery in Linyi Central Hospital were selected as DVT group,and the healthy women after delivery were selected as control group.The levels of CD40 L,and coagulation parameters,platelet function parameters,and inflammatory cytokines in peripheral blood were measured.Results The levels of CD40 L,D-dimer(D-D),fibrinogen(FIB),platelet activating factor(PAF),P-selectin,von Willebrand factor(v WF),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10),C-reactive protein(CRP)in peripheral blood of DVT group were statistically significantly higher than those in control group;the levels of prothrombin time(PT)and partially activated thrombin time(APTT)in DVT group were statistically significantly lower than those in control group(P<0.05).CD40 L was negatively correlated with APTT and PT(r=-0.592,-0.614,P=0.016,0.013).CD40 L was positively correlated with D-D,FIB,PAF,P-selectin,v WF,TNF-α,IL-10,CRP(r=0.531,0.557,0.657,0.459,0.573,0.691,0.496,0.539,P=0.022,0.020,0.008,0.032,0.018,0.003,0.030,0.022).Conclusion The increase of CD40 L in patients with postpartum DVT can promote coagulation,platelet aggregation,and inflammatory reaction activation.