Investigation Of The Relationship Between ApoM And The Coagulation Profiles After Major Orthopedic Surgery

Objectives:To investigate the change of apolipoprotein M (apoM) and coagulation profiles of the patients after major orthopedic surgery with deep vein thrombosis (DVT), analyze the correlation between apoM and coagulation profiles, and further more observe the relationships between those profiles and DVT.Methods:Sandwich ELISA was used to determine the serum apoM level in patient.15patients with major orthopedic surgery were included in this study. Serum levels of apoM, homocysteine (HCY), D-dimer (D-D), fibrin degradation products (FDP), fibrinogen (Fib) and the activity of antithrombin Ⅲ (AT-Ⅲ) before surgery and after6hours surgery. After the second blood sample collecting, low molecular weight heparin (LMWH) with conventional dose was injected by abdominal subcutaneous once daily for7days, then the same profiles as above were measured again. Comparing the serum levels of above profiles change among the three groups respectively and analyzing the correlation among the profiles of the same time.Results:The levels of apoM were decreased after the major orthopedic surgery. There were significant differences among the three time’s results of D-D, FDP, AT-Ⅲ and Fib respectively. The levels of apoM, AT-Ⅲ and Fib were increased finally after the first decline, while that of D-D, FDP changed oppositely. After using LMWH, the Fib level was increased significantly, and was negatively related to that of apoM (rank correlation coefficient rs=-0.709, P=0.005).Conclusions:ApoM participates in the acute phase response, and is closely related to the inflammatory response. ApoM can prevent the deep venous thrombosis after the major orthopedic surgery likely through the pathway of regulating the coagulation profiles.