Study On The Changes Of Platelet Parameters In Deep Venous Thrombosis And Its Correlation With Syndrome Types Of TCM

Objective: To explore the expression level of platelet parameters in DVT patients,the diagnostic value and the correlation with TCM syndrome types.Methods: in Study 1,667 DVT patients were selected as the observation group and 200 healthy examiners as the control group.The general data(sex,age,course of disease,location of disease,clinical classification and inducing factors)and detection indexes(PLT,MPV,PDW,PLT)were collected(PCT,P-LCR,Fib and D-dimer were compared.The observation group was stratified according to sex,age,location,stage,type and inducing factors,and the expression level of platelet parameters was observed under different factors.In Study 2,500 DVT patients were selected,including 286 cases in damp heat injection group,132 cases in blood stasis and dampness recombination group,82 cases in spleen kidney yang deficiency group,to explore the characteristics of the above indexes in different TCM syndromes and the value of their differential diagnosis.Results: Study 1 showed that:1.Compared with the control group,the MPV,PDW and P-LCR of DVT group decreased(P < 0.05),Fib and D-dimer increased(P < 0.01).2.Compared with the young group,the levels of MPV,PDW,PCT and P-LCR in the middleaged group decreased(P<0.05,P<0.01).The levels of PLT,MPV,PDW,PCT and P-LCR in the old group were lower than those in the young group(P<0.05,P<0.01).Compared with the middle-aged group,the PLT level of the old group decreased(P<0.05).According to the course of disease,the patients were divided into three groups: the PLT level in the subacute group was higher than that in the acute group(P<0.05);the PLT and D-dimer levels in the chronic group were lower(P<0.05),and the MPV,PDW and Fib levels were higher(P<0.05).Compared with the subacute group,the levels of PLT and PCT decreased(P<0.05,P<0.01),PDW and D-dimer increased(P<0.05,P<0.01).According to the clinical classification,the PLT and PCT of the central group were higher than those of the peripheral group(P<0.05),the PLT,PDW and P-LCR of the mixed group were lower(P<0.05),the MPV and PCT were lower(P<0.01),and the D-dimer was higher(P<0.01).Compared with the central group,PLT and PCT in the mixed group were significantly lower(P<0.01).The levels of PLT and PCT in patients with inducement group were significantly higher than those in patients without inducement group(P<0.01),while D-dimer was decreased(P<0.05).3.Single factor and two classification logistic regression analysis showed that age,Fib and D-dimer were the risk factors of DVT,and P-LCR was the protective factor.Multivariate logistic regression analysis showed that age,Fib and D-dimer were independent risk factors for DVT.4.Pearson correlation analysis showed that PLT was negatively correlated with MPV,PDW and P-LCR(P<0.01),and positively correlated with PCT(P<0.01);MPV was positively correlated with PDW and P-LCR(P<0.01),and negatively correlated with PLT(P < 0.01);PDW was positively correlated with MPV and P-LCR(P<0.01),and negatively correlated with PLT and D-dimer(P<0.01);P-LCR was positively correlated with MPV and P-LCR There was a positive correlation between PDW and PDW(P<0.01).5.The area under ROC curve of MPV,PDW and P-LCR was 0.587,0.604 and 0.584 respectively(P<0.01),and the area under ROC curve of D-dimer was 0.900,0.899 and 0.879 respectively(P<0.01).The Jordan index of PDW was 0.198,the sensitivity was 76.2%,and the specificity was43.6%.The Jordan index of MPV was 0.219,the sensitivity was 61.9%,and the specificity was 60.0%.The Jordan index of P-LCR was 0.206,the sensitivity was 46.0%,and the specificity was 74.6%.The results of the second study showed that: 1.The course of disease of damp heat type,blood stasis type and spleen kidney yang deficiency type increased in turn(P<0.05,P<0.01);compared with the damp heat type,the level of MPV and D-dimer in DVT patients of blood stasis type increased(P<0.05).The levels of MPV,PDW,P-LCR,Fib and D-dimer in the spleen kidney yang deficiency group increased(P<0.05,P<0.01).The levels of MPV,PDW and P-LCR in the spleen kidney yang deficiency group were higher than those in the blood stasis and dampness group(P<0.05).2.The area under ROC curve showed that MPV(AUC=0.6015),PDW(AUC=0.6154),P-LCR(AUC=0.6061),Fib(AUC=0.6164)and D-dimer(AUC = 0.7218)had statistical significance in the differential diagnosis of DVT with damp heat injection type and spleen kidney yang deficiency type(P<0.01);Fib(AUC=0.5929)and D-dimer(AUC=0.6731)had statistical significance in the differential diagnosis of DVT with heavy blood stasis and dampness type and spleen kidney yang deficiency type There was no statistical significance in the differential diagnosis of DVT(P>0.05).Conclusion: Platelet parameters are closely related to the formation of DVT,and their expression levels are different in different ages,stages,types and inducements,which provides a certain reference value for the clinical diagnosis and disease assessment of DVT;the expression levels of platelet parameters in different TCM Syndromes of DVT are different,which is an effective supplement for TCM syndrome differentiation and classification of DVT.