Correlation of four items of thrombosis TM,TAT,PIC and tPAIC with the occurrence of lower extremity deep vein thrombosis and anticoagulant effect

JIANG Wei; CHANG Xiandong; CHEN Jianhua

doi:10.3969/j.issn.1002-7386.2025.10.008

Abstract：Objective To analyze the correlation of thrombomodulin(TM),thrombin-antithrombin complex(TAT),plasmin-alpha 2-plasmin inhibitor complex(PIC)and tissue plasminogen activator-plasminogen activator inhibitor-1 complex(tPAIC)with the occurrence of deep vein thrombosis(DVT)and the anticoagulant effect in fracture patients treated with surgery,and to investigate the evaluation value of each index on the occurrence of DVT and anticoagulation effect.Methods From June 2021 to June 2023,102 fracture patients with postoperative lower extremity DVT were enrolled in the study group,and 90 fracture patients without postoperative DVT during the same period were selected in the control group.Anticoagulation therapy was performed in all patients with lower extremity DVT,and they were divided into the effective group(n=84)and ineffective group(n=18)according to the therapeutic effect.Plasma levels of TM,TAT,PIC and tPAIC were measured on the next day after surgery.Spearman rank correlation analysis was performed to analyze the correlation of plasma TM,TAT,PIC and tPAIC with the occurrence of lower extremity DVT and anticoagulant efficacy.The evaluation value of plasma levels of the four items in postoperative lower extremity DVT and anticoagulant efficacy in fracture patients was analyzed by the receiver characteristic operating curve(ROC).Results Plasma TM,TAT,PIC and tPAIC in the study group were significantly higher than those of the control group,which were significantly higher in the ineffective group than the effective group(P＜0.05).Spearman rank correlation analysis showed that plasma TM,TAT,PIC and tPAIC were positively correlated with the occurrence of lower extremity DVT(r=0.337,0.362,0.504,and 0.342,respectively;P＜0.05),and negatively correlated with the anticoagulant effect(r=-0.269,-0.254,-0.312,and-0.258,respectively;P＜0.05).ROC curve analysis results showed that the area under the curve(AUC)of a combination of plasma TM,TAT,PIC and tPAIC in predicting lower extremity DVT was 0.943,with the sensitivity of 88.24％,and specificity of 90.00％,showing a better performance than the single indicator(P＜0.05).The AUC of the combined evaluation of plasma TM,TAT,PIC and tPAIC levels in predicting the anticoagulant effect was 0.893,with the sensitivity of 98.70％,and specificity of 89.29％,showing a better performance than the single indicator(P＜0.05).Conclusion Plasma levels of TM,TAT,PIC and tPAIC are closely related to the occurrence of lower extremity DVT and anticoagulant effect.The early measurement of TM,TAT,PIC and tPAIC levels can provide a certain reference value for the occurrence of lower extremity DVT and anticoagulant effect.