关节置换围术期患者血浆内皮细胞蛋白C受体和血栓调节蛋白水平变化分析

摘要

Objective To evaluate the level of plasma endothelial cell protein C receptor (EPCR) and thrombomodulin (TM)in the perioperative period of artificial joint replacement.Methods 119 patients (male 32,female 87,age distribution 57.75 ±12.04) who underwent total knee replacement and total hip arthroplasty from March to June 2015 in Department of Orthopedics of Beijing Jishuitan Hospital were selected.The levels of plasma endothelial cell EPCR and TM were compared be fore and after operation for 1 and 3 days.Results ①The concentration of plasma EPCR on the first day after surgery was reduced by 40.34％ compared with preoperative,and on the third day after surgery reduced by 49.45％ compared with pre operative,and on the third day after surgery was reduced by 15.26％ compared with the first day after surgery.The differences were all statistically significant (F=5.63,P＜0.05).②The concentration of plasma TM on the first day after surgery was reduced by 12.77％ compared with preoperative,and on the third day after surgery reduced by 40.53％ compared with preoperative,and on the third day after surgery was reduced by 31.83％ compared with the first day after surgery.The differences were all statistically significant (F=7.87,P＜0.05).Conclusion The concentration of EPCR and TM were pro gressively reduced within 3 days after arthroplasty.%目的 评估血浆内皮细胞蛋白C受体(endothelial cell protein C receptor,EPCR)和血栓调节蛋白(thrombomodulin,TM)在人工关节置换术围术期的水平变化.方法 119例(男32例,女87例,年龄57.75±12.04岁)于2015年3～6月间在北京积水潭医院矫形骨科接受全膝关节置换术和全髋关节置换术的患者,观察其在术前、术后第1天和第3天血浆内皮细胞EPCR和TM的浓度变化.结果 ①血浆EPCR浓度术后第1天与术前相比减低40.34％,术后第3天与术前相比减低49.45％,术后第3天与术后第1天相比减低15.26％,差异均具有统计学意义(F=5.63,均P＜0.05);②血浆TM浓度术后第1天与术前相比减低12.77％,术后第3天与术前相比减低40.53％,术后第3天与术后第1天相比减低31.83％,差异均具有统计学意义(F=7.87,均P＜0.05).结论 关节置换术后3天内EPCR和TM水平进行性减低.