The Expression And Clinical Significance Of Thrombomodulin In Patients With Post-traumatic Deep Venous Thrombosis

Objective:To compare the levels of plasma thrombomodulin(TM) in healthy people,patients without post-traumatic DVT and patients with post-traumatic DVT,and to explore the significance of TM in the diagnosis of post-traumatic DVT and the diagnostic value of TM combined with D-dimer in post-traumatic DVT.Methods: 73 cases of trauma patients with D-dimer > 0.5ug/ml admitted to the Third Hospital of Hebei Medical University from May 2017 to December 2020 were collected.The patients were divided into non thrombus group(n = 35)and thrombus group(n = 38)according to the results of color Doppler ultrasound,and 20 healthy adults(healthy group)were selected for physical examination in our hospital at the same period.The expression levels of TM and D-dimer in plasma of each group were detected Receiver operating characteristic curve(ROC)was used to analyze the value of the two methods in the diagnosis of DVT after trauma.Results:The levels of TM expression in plasma of non thrombus group and thrombus group were(1647.351 ± 265.955)pg/ml and(2008.108 ±339.457)pg/ml respectively,which were significantly higher than those of healthy group(1047.210 ± 291.030)pg/ml(t = 7.633,P < 0.017;t= 10.563,P <0.017);the level of TM expression in plasma of thrombus group was significantly higher than that of non thrombus group(t= 4.956,P<0.017).When diagnosing DVT,the area under ROC curve(AUC)of combined detection of TM and D-dimer was 0.823,which was significantly higher than that of single detection of TM and D-Dimer(0.820,0.611).Logistic regression analysis showed that the specificity of combined detection of TM and D-dimer was 80.0%,which was higher than that of single detection of TM and D-Dimer(71.4%,54.3%);the accuracy was 80.8%,which was higher than that of single detection of TM and D-Dimer(78.1%,60.3%).Conclusions: The expression level of TM is higher in trauma patients and higher in post-traumatic DVT patients.The detection of TM and D-dimer in plasma is of great significance for the diagnosis of DVT in trauma patients.The combined detection of TM and D-dimer can improve the specificity and accuracy of post-traumatic DVT diagnosis,which is helpful for the early diagnosis of DVT in trauma patients.