Changes In Protein C,Antithrombin Ⅲ,Lupus Anticoagulant And D-Dimer Levels In DVT Patients And Their Relationship With Traditional Chinese

Objective: To observe the characteristics of protein C(PC),antithrom bin III(AT-III),lupus anticoagulant(LA)and D-dimer levels in deep vein thrombosis(DVT)and the changing patterns of the above indicators before and after treatment and their relationship with TCM syndromes of DVT.Methods: Study 1: 60 DVT patients who met the discharge criteria in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were collected as the observation group,and 30 healthy patients were collected as the control group.The general indicators(sex,age,clinical classification,clinical staging)and monitoring indicators(PC activity,AT-III activity,LA screening ratio,D-dimer)of the two groups were collected,and the differences of the above indicators between the two groups were analyzed and to explore the diagnostic value of the monitoring indicators for DVT.Study 2: A total of 60 DVT patients who met the TCM differentiation classification criteria were selected,including 30 cases in the damp heat type group and the blood stasis and dampness type group,and observe the differences of the above indicators between different TCM syndromes of DVT.The patients of the damp heat type group was given Simiao Yongan decoction and the patients of the blood stasis and dampness type group was given Yin Chen Chi Xiao Dou decoction,in both groups,patients were given Chinese herbal injection,external application of Bing Xiao Dispersions,anticoagulation and thrombolytic therapy,and the changing patterns in the above indicators and their relationship with the TCM syndromes were analyzed 14 days after treatment.Results: Study 1:1.No significant differences in gender and age of DVT patients compared to control group(P>0.05).2.PC activity and AT-III activity in DVT patients were lower than those in the control group(P<0.05),LA screening ratio and the level of D-dimer was higher than that in the control group(P<0.01).3.Binary classification logistic regression analysis showed that PC activity and AT-III activity were independent protective factors of DVT,and D-dimer was an independent risk factor for DVT.4.The ROC curved areas of PC activity,AT-III activity and D-dimer were 0.639,0.683 and 0.924.PC activity and AT-III activity had a low degree of diagnostic value for DVT,and D-dimer had a high degree of diagnostic value for DVT.Study 2: 1.There was no significant differences in the gender,age and clinical classification of patients in the damp heat type group compared with the blood stasis and dampness type group(P>0.05).Patients in the damp heat type group were predominantly in the acute stage,while the blood stasis and dampness type group was predominantly in the subacute and chronic stages(P<0.01).2.Before treatment,PC activity,AT-III activity and the level of Ddimer in the damp heat type group were higher than those in the blood stasis and dampness type group(P<0.01),and there was no significant difference in LA screening rates compared to the blood stasis and dampness type group(P>0.05).3.After 14 days of treatment,PC activity and AT-III activity in the two groups were higher than those before treatment(P<0.05),LA screening ratio was lower than that before treatment,among which there was significant difference between the damp heat type group and before treatment(P<0.01),the blood stasis and dampness type group was significantly different from that before treatment(P<0.05),and the level of D-dimer decreased compared with before treatment(P<0.01).4.After 14 days of treatment,PC activity,ATIII activity and the level of D-dimer in the damp heat type group were still higher than those in the blood stasis and dampness type group(P<0.01),and there was no significant difference in LA screening rates compared to the blood stasis and dampness type group(P>0.05).Conclusion: PC,AT-III,LA and D-dimer are closely related to the development of DVT,PC and AT-III are independent protective factors of DVT,D-dimer is an independent risk factor of DVT.PC,AT-III,LA,Ddimer has certain reference value for the diagnosis and early prevention of DVT.The expression levels and changing patterns of PC,AT-III,LA and D-dimer in different TCM syndromes of DVT before and after treatment are different,which not only provide objective criteria for the differentiation of TCM syndromes of DVT from the perspective of microscopic diagnosis,but also provide an objective basis for the clinical treatment effect of DVT.