Expression And Sigificance Of Pecam-1 And Vcam-1 In Organization And Recanalization Of Thrombosis Of Lower Extremity Deep Venous Thrombosis With PTS

The development of the lower extremity deep venous thrombosis with post thrombotic syndrome is determined by the organization and recanalization of thrombosis. Some studies have indicated that cell adhesion molecules play an important role in the organization and recanalization of thrombosis. At present, adhesion molecules known as dozens of species,the formation of adhesion molecules, including immunoglobulin family, integrin family, lectin family and etc. Platelet endothelial cell adhesion molecule-1( Pecam-1) and vascular cell adhesion molecule-1( Vcam-1) are two kinds of adhesion molecules.Pecam-1 mainly inhibits platelet adhesion, aggregation and activation. The inflammatory response of vascular wall and the chemotaxis of inflammatory cells are mediated by Vcam-1, but the evolution process and the effect of Pecam-1 and Vcam-1 in organization and recanalization of thrombosis of lower extremity deep venous thrombosis with PTS remains not clear.Objective: To observe the variation tendency of Pecam-1 and Vcam-1in lower extremity deep venous thrombosis with PTS. To understand The role and the significance of adhesion molecule and inflammation reaction in organization and recanalization of thrombosis in lower extremity deepvenous thrombosis with PTS.Methods: 1. 206 patients with lower extremity deep vein thrombosis were be followed up for 1 years in hospital from January 2014 to March2014. Each sample was be detected by euzymelinked immunosorbent assay to get the values of platelet endothelial cell adhesion molecule-1, vascular cell adhesion molecule-1,IL-4,IL-8, thromboelastography, coagulation function and others in no recanalization group(PTS without recanalization, n=68), partial recanalization group(PTS with partial recanalization, n=37), recanalization group(PTS with recanalization, n=22)and deep venous thrombosis group(lower extremity deep vein thrombosis without PTS, n=60). The relationship between Pecam-1 and MA was also be detected.2. Vcam-1 and Pecam-1 were be detected by ELISA in no recanalization group,partial recanalization group,recanalization group and deep venous thrombosis group at the point of admission, discharge, 3month, 6 month and 12 month after admission.Results: 1. Platelet endothelial cell adhesion molecule-1 and vascular cell adhesion molecule-1 were higher in the no recanalization group than those in the partial recanalization group(P<0.05),and Pecam-1 and Vcam-1in the partial recanalization group were higher than those in the recanalization group(P<0.05). 2. The changes of Pecam-1,Vcam-1 and MA were not significant in the no recanalization group with the extension of time.Pecam-1 and Vcam-1 decreased in partial recanalization group and recanalization group with the extension of time, and MA increased in the two groups, there was a trend to restore stability.3. MA in No recanalization group was lower than that in partial recanalization group(P<0.05), and MA in partial recanalization group was lower than that in recanalization group(P<0.05). Correlation between platelet endothelial cell adhesion molecule-1 and MA(P<0.05). 4. IL-4, IL-8, white blood cell and neutrophil cellpercentage in no recanalization group were higher than that of partial recanalization group(P < 0.05), those in partial recanalization group were higher than that of recanalization group(P < 0.05). There was no statistical significance of platelet count and coagulation function among the four groups(P > 0.05). there was no significant correlation between Pecam-1 and coagulation function, blood routine(P > 0.05).Conclusion: Platelet endothelial cell adhesion molecule-1, vascular cell adhesion molecule-1 and inflammatory reaction are involved in the organization and recanalization of thrombosis in lower extremity deep venous thrombosis with PTS. The degree of activation of Pecam-1 and Vcam-1 as well as the degree of inflammatory reaction is inversely proportional to the degree of recanalization of thrombus with lower extremity deep venous thrombosis with PTS.