| Up to now , there are a lot of review about cause of deep vein thrombosis ( DVT) , and many of articles have been given internal and external . We first analyzed the possible acquired causes which might be related to thrombosis , such as malignancy, diabetic meditus, nephritic syndrome,myeloproliferative disorders, immobilization, pregnancy , or use of the oral contraceptive pill etc . Although , there are not these risk factors in patients of DVT . For example , factor V lei-den are established risk factors for venous thrombembolisn in Europen , however , the same phenomenon was not found in the asian . The study reveals that factor V leiden mutation is absent in venous tnrom-bophilic asian patients . Moreover , anticoagulation system - fibrinoly-sis are measurable by products of zymogen activation include D - dimer ( D - D) fibrin degradation products formed by the action of plas-rnin on cross linked fibrin , D - D is a sensitive marker of plasma in excluding a diagnosis of recurrrnt DVT . The purpose of this study was therefore to document changes and to evaluate their utility of APC and D - D in plasma during the development of DVT .Materials and methodsSubjects : The patients who were confirmd to suffer deep venous thrombosis within three days by Doppler ultrasound scan were involved , those who had severe heart or lung dysfunction , prediagnosed malignant tumor , diabetic meditus or other connective diseases were excluded , the control ones were selected who had no any sign of DVT , other exclusive standards just as the treatment group , those who addicted in smoking were excluded , too . 21 patients entered into the study ( male 9 , female 12 , their mean age were 59. 6 ± 10.7 years ) 8 control ones were selected ( male 3 , female 5 , their mean age were 54.12 ± 14.6 years )Methods : Blood samples were drawn from all patients and control ones . For the patients with recent thrombosis , it was drawn before anticoagulant or thrombolytic therapy . 2ml whole blood , antico-agulated by heparin , were obtained at the time the patients in hospital , defined by tl . After 72hs medical treament , a second samples were obtained , defined by t2 . Plasma were obtained within 1 hour by centrifuged at 3000r for 10 minute at room temperature (20℃ -25℃ ) and were collected into a tube in a 1/10 vol of 3. 8% (wt/vol) trisodium citrate , stored at -70℃ until use . Quantitative D-D levels were determined with an enzyme - linked immunosorbent assay ( ELISA) , APC levels were measured by chromogenic APC reaction . Also , data of Aptt,Pt,Fib and Pit were obtained by t1 . Methods of the control ones as same as that of the patients.Statistical analysis : Data were expressed as the mean standard deviation , statistical differences between two groups were assessed bythe T test and correlative analysis , respectively . Statistical significance was defined at a P value of 0.05 or less.ResultsAll patients have not pulmonary embolism and severer infection in time of treament . After three days , 6 of them haven t been obtained blood samling of t2 . in other 15 patients , 9 of them were no more alleviated in leg swell than that of tl . But , 6 of them have not relieved in leg swell and have to were operated . Statistical analysis indicated that all patients were detected to have an apparent lower APC levels at tl than the control ones (p <0.001) , and have an apparent higher D - D levels at tl than the control ones ( p <0.001) . At t2 , the APC and D-D levels have not significant difference between relieved patients and severer patients ( p > 0. 05 ) , and have not significant difference in the coagulation abilities and platelet counts between the patients and the control ones (p >0.05) . There were no evident correlation between the levels of plasma APC or D - D and either the a-mount of platelet or fibrinogen ( p > 0.05 ) .DiscussionNowadys, the study of deep venous thrombosis (DVT) is more than that of the past. Original , expert's viewpoint considered that DVT were caused by geni... |
