Predictive value of plasma platelet factor 4 and chemokine CX3C receptor 1 for deep vein thrombosis after cesarean section in patients with severe preeclampsia

Yang Caixia; Li Junxia; Li Jiarong; Xie Ruiping

doi:10.3760/j.issn.1673-4777.2026.05.020

Abstract：Objective To investigate the predictive value of plasma platelet factor 4(PF4)and chemokine CX3C receptor 1(CX3CR1)for deep vein thrombosis(DVT)after cesarean section in patients with severe preeclampsia.Methods A total of 302 patients with severe preeclampsia who underwent cesarean section at Shanxi Children's Hospital from March 2020 to December 2024 were prospectively enrolled.According to the occurrence of DVT within 2 weeks after operation,the patients were divided into DVT group(72 cases)and non-DVT group(230 cases).Plasma levels of PF4 and CX3CR1 were measured preoperatively in all patients,and clinical data as well as laboratory indicators including fibrinogen and D-dimer were collected and compared.Pearson correlation analysis method was used to analyze the correlation of PF4 and CX3CR1 with fibrinogen and D-dimer.Multivariate Logistic regression analysis was performed to identify the risk factors of DVT after cesarean section in patients with severe preeclampsia.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of PF4 and CX3CR1 for postoperative DVT.Results Body mass index,proportion of gesta-tional diabetes mellitus,proportion of prolonged bed rest for fetal preservation,fibrinogen and D-dimer levels in DVT group were significantly higher than those in non-DVT group(all P＜0.05).Plasma levels of PF4 and CX3CR1 in DVT group were significantly higher than those in non-DVT group[(6.3±1.9)μg/L vs(3.0±0.7)μg/L,(82±16)ng/L vs(43±10)ng/L](t=22.274,25.139,both P＜0.001).Plasma levels of PF4 and CX3CR1 were positively correlated with fibrinogen and D-dimer in DVT group(all P＜0.001).Multivariate Logistic regression analysis showed that gestational diabetes mellitus,high body mass index,high PF4 and high CX3CR1 were independent risk factors for DVT after cesarean section in patients with severe preeclampsia(all P＜0.05).The area under the curve(AUC)of PF4 and CX3CR1 alone for predicting postoperative DVT was higher than that of gestational diabetes mellitus and body mass index,respectively,and the AUC of the combined prediction of PF4 and CX3CR1 was higher than that of each single indicator(all P＜0.05).Conclusions High preoperative plasma levels of PF4 and CX3CR1 are associated with the occurrence of postoperative DVT in patients with severe preeclampsia.The combination of PF4 and CX3CR1 has high value in predicting the risk of postoperative DVT.