Zhongguo linchuang yanjiu (Jul 2024)
Predictive value of dynamic assessment of thrombose-related factors in diabetic nephropathy patients for thrombotic risk
Abstract
"Methods A retrospective study was conducted to select 98 patients with DN who were treated in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to September 2022. Follow-up was conducted after treatment, with the occurrence of deep vein thrombosis as the observation endpoint. Finally, 96 patients obtained follow-up and were divided into the thrombosis group (n=21) and the non-thrombosis group (n=75) based on the presence or absence of thrombosis. The clinical data of patients were collected, and the influencing factors of thrombotic risk of DN patients were analyzed by univariate and multivariate logistic analysis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of thrombose-related factors ［thrombin-antithrombin complex (TAT), plasmin-α-2-plasmin inhibitor complex (PIC), tissue plasminogen activator/plasminogen activator 〖JP+1〗inhibitor-1 complex (t-PAIC) and soluble thrombomodulin(sTM)］〖LM〗 for thrombotic risk in DN patients. Results There was no significant difference in general information, duration of diabetes, glucose metabolism, lipid metabolism and renal function between the two groups (P＞0.05). The differences in prothrombin time (PT), activated partial thromboplastin time (APTT) and D-dimer (D-D) between the two groups were statistically significant(P＜0.05). In the thrombosis group, the levels of TAT, PIC, t-PAIC and sTM before and after treatment, the difference between pro-treatment and post-treatment, and the variation coefficient between pro-treatment and post-treatment were all increased compared to the non-thrombosis group(P＜0.01). Multivariate logistic regression analysis showed that the increased variation coefficients of TAT, PIC, t-PAIC and sTM (OR=3.367,P=0.010;OR=19.106,P=0.042;OR=4.313,P=0.005;OR=9.389,P=0.003) were the independent risk factors affecting the thrombotic risk in DN patients. The ROC curve results showed that the AUCs of the variation coefficients of TAT, PIC, t-PAIC and sTM in predicting the thrombotic risk in DN patients were 0.818, 0.806, 0.873 and 0.825, respectively. Conclusion Elevated levels of thrombose-related factors are the independent risk factors for thrombosis in DN patients, and TAT, sTM, PIC, and t-PAIC can be used as important indicators to predict their thrombotic risk. "
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