الفهرس 
DEEP VENOUS THROMBOSISOnly 14 pages are availabe for public view
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Abstract
V
enous thromboembolic disease (VTE) remains a significant source of morbidity and mortality. As non-specific subjective complaints and a lack of objective clinical examination findings complicate the diagnosis of both deep venous thrombosis (DVT) and pulmonary embolism, Objective diagnostic testing is required to confirm or exclude the presence of venous thromboembolism before subjecting patients to unnecessary long-term anticoagulation.
Compression ultrasound remains the gold standard for DVT diagnosis. Reliable imaging is not always available making a serologic diagnosis, or biomarker, highly required. While D-dimer, a highly sensitive biomarker, is useful for excluding acute VTE, it lacks the specificity necessary for diagnostic confirmation. while the other is inflammatory markers, including P-selectin and microparticles, CRP, IL10.
The purpose of the present study was to determine the significance of CRP, P-selectin in DVT and whether they serve as good clinical markers for DVT.
This study was conducted on 80 individuals; 50 patients who were positive for DVT by duplex scanning (group I) and 30 control individuals (group II). All patients were subjected to full medical history taking, thorough clinical examination, duplex ultrasound, complete blood counts, PT and APTT together with CRP and P-selectin testing.
Regarding the demographic (age and gender) and clinical features including obesity, smoking, use of OCPs, history of previous surgery and personal or family history of DVT, they revealed statistically insignificant difference between all studied groups.
Regarding different laboratory variables, no statistically significant associations were detected between different studied groups. However, highly significant differences were detected between different studied groups as regards CRP and P-selectin levels.
CRP value ranged from 6 to 96 mg/l in group I, howrver in group II CRP value of < 6 mg/l.
While P-selectin value in group I, ranged from 70.5 to
109.5 (ng/ml) and in group II, ranged from 4 to 27.5 (ng/ml).
On analyzing the receiver operator characteristic (ROC) curve to establish the cut-off levels of the P selectin in the diagnosis of DVT, P-selectin expression level of 70.5 ng/ml can accurately differentiate patients who were positive for DVT on duplex scanning from control group.
Regression analysis models were used to sort the different studied markers according to their importance and revealed that, P-sel is the most promising novel biomarker for DVT diagnosis, and offers increased specificity, with the possibility of being able to rule in DVT.