[The diagnostic value of plasma fibrin related markers in perioperation of femoral fracture].
Objective:To investigate potential value of fibrin related markers in patients with femoral fracture during perioperative period.Methods:Ninety-five patients were enrolled, including 39 males with (53±24) years old and 56 females with (73±13) years old, of which 44 fracture on caput femoris, 34 collum femoris and 17 shaft of femur. Sampling on the day before operation and 1(st,) 3(rd,) 5(th) days after operation, fibrin monomer (FM), D-dimer(DD), fibrinogen degradation product (FDP) and other coagulation assays were detected by reagents from Stago. Difference in day-to-day and between surgical sites were analyzed with general linear model (repeated measures).Results:FDP level on pre-operation, 1(st,) 3(rd,) 5(th) day after operation were 7.88(5.19, 12.12), 15.68(9.84, 29.48), 8.44 (6.27, 12.49) and 10.28 (7.56, 14.00) mg/L, the value of fibrin monomer were 5.00 (5.00, 6.03), 9.89(5.04, 30.12), 5.00 (5.00, 6.04) and 5.02(5.00, 5.76) mg/L. The value of D-Dimer were 2.24(1.41, 3.60), 4.78(2.74, 9.18), 2.60(1.79, 3.88) and 2.91(2.20, 3.85) mg/L, respectively, each parameter changs statistically during observation (Z=4.758, 6.027, 3.238 respectively,P<0.05). On the 5th day after surgery, fibrin monomer in patients with venous thrombus embolism (VTE) were higher than that in patients without VTE, 10.18(7.24, 28.11) mg/L vs 5.10(5.00, 6.73) mg/L (Z=-1.580,P<0.05), which showed potential value evaluating of post-operative VTE. No statistical changes were found in prothrombin time or thrombin time (TT) (P>0.05), but activated partial thromboplastin time (APTT) varied from day to day in (38.1±4.9), (40.8±5.2), (45.1±6.2) and (41.9±6.3)s with statistically difference (F=7.127,P<0.05). Similarly, fibrinogen changed statistically in (5.01±0.94), (4.99±1.35), (6.00±1.75), (5.81±1.38)g/L (F=8.927,P<0.05).Conclusion:Fibrin monomer, additional to markers as D-dimer, shows its value on activated coagulation associated to post-operative thromboembolism for patients receiving femoral surgery.
Department of Clinical Laboratory, Chinese PLA General Hospital, Beijing 100853, China.
J
J
Li
Department of Clinical Laboratory, Fu Xing Hospital, Capital Medical University, Beijing 100038, China.
Z
Z
Chen
L H
LH
Zhang
Z L
ZL
Li
D M
DM
Wu
S S
SS
Wang
L J
LJ
Xu
H
H
Xu
P F
PF
Tang
C B
CB
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D005260:Female; D005264:Femoral Fractures; D005337:Fibrin / Q000032:analysis*; D005338:Fibrin Fibrinogen Degradation Products; D005340:Fibrinogen; D006801:Humans; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D013927:Thrombosis
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C011468:fibrinmonomer; D005337:Fibrin; D005340:Fibrinogen
Femoral fractures; Fibrin; Venous thromboembolism