| Background and ObjectiveVenous thromboembolism (VTE) includes deep vein thrombosis (DVT) andpulmonary thromboembolism (PTE), DVT and PTE are not two independent diseases,but a continous process of VTE. The clinical diagnostic methods of patients with VTEare determined by the CT pulmonary arterial angiography, radioavtive nuclide lungventilation/perfusion scan, magnetic resonance angiography and pulmonary arterialangiography etc. Up to mow, these detections are not only popular in the world, but alsocontraindication to sevious patients or patients with hypersensitiveness. Therefore, thereis a challenge to explore a simple and cheap method with high sensitivity and speciticityfor patients with VTE on early stage.In this study, we detected the dynamic changes of plasma soluble fibrin complexes(SFC), coagulation factor ⅩⅢ(FⅩⅢ) and D-dimer levels, in order to understand theVTE pathophysiology and the significance of the above plasma markers through ratmodel with VTE.Materials and Methods18Sprague-Dawley rats were randomly divided into DVT group, DVT-PTE groupand Sham group. The left femoral vein was blocked using a microvessel clip to formDVT in DVT group. Three-day-old thrombi after DVT were injected into the rightfemoral vein to induce PTE in DVT-PTE group. The left femoral vein was onlyseparated in sham group.The contents of SFC, FⅩⅢand D-dimer in the plasma weremeasured by the enzyme linked immunosorbent assay (ELISA) at0h,3hs,6hs,12hs,1d,2ds,3ds after DVT or PTE or the operation respectively. The data were analyzed withstudent’s t test or Oneway ANOVA.Statistical significance was assigned for P<0.05.Results1. The level of plasma SFC In DVT group, the level of plasma SFC reached to the peak value at2ds (19.795±9.626ug/ml) after DVT, which was higher than that at0h (4.108±0.809ug/ml)(t=2.923，P=0.033). The level of plasma SFC did recover to the normal level at3ds.In DVT-PTE group,the level of plasma SFC reached the peak value at3hs(22.643±19.417ug/ml) after DVT-PTE, which was not significantly higher than beforeembolization（t=2.213，P=0.078）, The level of plasma SFC did not recover to thenormal level at2-3ds（11.212±12.742ug/ml，11.138±11.839ug/ml）,but which wasnot significantly different compared to that at0h(t=1.147，P=0.303；t=1.216，P=0.278）.In Sham group, the level of plasma SFC reached to a higher level(17.816±4.702ug/ml) at3hs,12hs reached the peak value(24.322±1.101ug/ml),which wassignificantly different compared to that at0h（3.698±0.676ug/ml）(t=6.607，P=0.007；t=43.729，P=0.000）,to3ds recovered the normal level.2.The level of plasma FⅩⅢIn DVT group,the level of plasma F ⅩⅢ reached to the peak value at6hs(557.685±473.435ng/ml) after DVT,which was higher than that at0h（77.563±22.949ng/ml）（t=3.204，P=0.029）,The level of plasma FⅩⅢ did not recover to thenormal level at3d（s291.523±206.034ng/ml）, but which was not significantly differentcompared to that at0h（t=2.259，P=0.073）.In DVT-PTE group, FXIII level reached to the peak value at3hs (638.716±674.793ng/ml)，which was not significantly higher than before embolization（242.180±26.282ng/ml）（t=1.449，P=0.207）.In Sham group, the level of plasma FⅩⅢ reached to the peak value at2ds(554.295±180.036ng/ml),which was significantly different before surgery（94.716±13.475ng/ml）（t=5.517，P=0.012）, The level of plasma SFC did not recover to thenormal level at3d（s398.217±214.255ng/ml）, but which was not significantly differentcompared to that at0h（t=2.670，P=0.076）.3. The level of plasma D-dimerIn DVT group, the level of plasma D-dimer reached to the peak value at6hs（353.380±74.235ng/ml）, which was higher than that at0h(40.316±4.345ng/ml)(t=2.298,P=0.03),maintained to24hs(（229.159±181.274ng/ml）（t=2.995，P=0.02）,recovered to normal level at3ds.In DVT-PTE group, the level of plasma D-dimer reached to the peak value at12-24hs（476.576±317.067ng/ml；481.177±322.763ng/ml）,which was significantlyhigher than before embolization（55.785±10.489ng/ml）(t=3.18，P=0.025；t=3.159， P=0.025）.The level of plasma SFC did not recover to the normal level at2-3d（s382.956±341.929ng/ml，381.943±346.108ng/ml），but which was not significantly differentcompared to that at0h（t=2.361，P=0.065；t=2.327，P=0.067）.In Sham group, the level of plasma D-dimer began to increase at3hs(450.881±165.966ng/ml)（t=6.071，P=0.000）,24hs reached the peak value (504.488±124.615ng/ml),which was significantly higher than before surgery（51.050±6.795ng/ml）（t=9.170，P=0.000）,2-3ds recovered to the normal level.Conclusions1. The level of plasma coagulation-fibrinolytic markers including SFC、FⅩⅢandD-dimer are increased and sensitive for experimental VTE, but they are nonspecific.2. The changes of plasma coagulation-fibrinolytic markers are not completely atequal in DVT and DVT-PTE group. DVT is a process of thrombosis, then which isdissolved with the increasement of plasma of SFC、FⅩⅢand D-dimer; while PTE ismainly a process of embolus being dissolved, the changes of plasma SFC and FⅩⅢarenot obvious.3.Surgical operation maybe cause the increasement of plasma coagulation-fibrinolytic markers including SFC, FⅩⅢand D-dimer, so it is a risk facror of VTE. |
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