Abstract:Objective: To investigate the expression levels of angiopoietin like protein 8 (ANGPTL8) and CXC chemokine ligand 16 (CXCL16) in serum of patients undergoing total knee replacement, and their correlation with lower extremity deep vein thrombosis. Methods: A total of 110 patients who underwent total knee arthroplasty at our hospital between December 2016 and June 2022 were enrolled. Serum ANGPTL8 and CXCL16 levels were measured by enzyme-linked immunosorbent assay (ELISA) preoperatively and 7 days postoperatively for comparison. Patients were divided into non-deep vein thrombosis (non-DVT) group (n=76) and deep vein thrombosis (DVT) group (n=34) based on whether they developed lower extremity DVT. General characteristics were compared between the two groups. Pearson correlation analysis was performed to examine: 1) the correlation between serum ANGPTL8 and CXCL16 levels, and 2) their association with DVT occurrence. Multivariate logistic regression analysis was conducted to identify risk factors for DVT in TKA patients. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum ANGPTL8 and CXCL16 levels for DVT development. Results: 7 days after the surgery of total knee replacement, Serum ANGPTL8 and CXCL16 were significantly lower than preoperative (t=9.189,5.773, P=0.000) and serum ANGPTL8 and CXCL167d in lower extremity deep veinthrornbosis group was higher than that in non lowere extremity deep vein thrombosis group (t=1.96 1,7.580,1.029,8.095,P=0.052,0.000,0.306,0.000); there were obvious differences in age, hypertension history, operation time, bed rest time and body mass index between lower extremity deep vein thrombosis group and non lower extremity deep vein thrombosis group (P<0.05); the levels of serum ANGPTL8 and CXCL16 were obviously and positively correlated with the occurrence of lower extremity deep vein thrombosis (r=0.728, 0.856, P=0.001, 0.000); there was a obvious positive correlation between serum ANGPTL8 level and CXCL16 level in patients with total knee replacement (r=0.538, P=0.000); serum ANGPTL8, CXCL16, history of hypertension, operation time and bed rest time after operation were the influencing factors of lower extremity deep vein thrombosis in patients undergoing total knee replacement (P<0.05); the AUC predicted by the combination of serum ANGPTL8 and CXCL16 in patients undergoing total knee replacement was 0.986, with a sensitivity of 94.12% and a specificity of 95.37%, which was better than their separate prediction (Zcombination-ANGPTL8=2.193, Zcombination-CXCL16=2.343, P=0.028, 0.019). Conclusion: The levels of serum ANGPTL8 and CXCL16 in patients with total knee replacement 7 days after operation are obviously lower than those before operation, in addition, patients with lower extremity deep vein thrombosis have higher levels of serum ANGPTL8 and CXCL16, the combined detection of the two can better evaluate the occurrence of lower extremity deep vein thrombosis in patients undergoing total knee replacement.
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