Clinical Application Study of Plasma Thrombmodulin.

Objective: To investigate the clinical value of plasma thrombmoclulin (PTM).

Methold: PTM was determined in 979 patients and 60 healthy controls with ELISA method.

Result: The PTM of the control group was 20.40±7.72 μg/L, there was no difference in genders and ages. The PTM of the patients with microangiopathy were higher than that of the patients with macroangiopathy (P <0.01). We defined PTM level higher than its normal upper limit (35.54μg/L) as PTM positive, in microangiopathy diseases, the sensitivity of PTM was 77.7%, the specificity was 71.2% and the positive predictive value was 75.6%. In chronic primary glomerular disease, the PTM of chronic renal failure (CRF) group was higher than that of non-CRF group (P <0.01), the sensitivity was 85.7%, the specificity was 82.4%, the positive predictive value was 77.8%. The PTM level in septemia group was higher than that of non-septemia group(P <0.01),the sensitivity of PTM was 86.6%, the specificity was 89.5% and the positive predictive value was 76.5%. In multiple trauma, the PTM of multiple organ failare (MOF) group was higher than that of non-MOF group (P <0.01), the sensitivity of PTM was 77.8%, the specificity was 77.3% and the positive predictive value was 73.7%. In systemic lupus erythematosus (SLE), the PTM of the patients with albuminuria was higher than that of the patients without albuminuria(P <0.01), the sensitivity was 77.8%, the specificity 92.3% and the positive predictive value was 93.3%. In diabetes, the PTM of complication group was higher than that of no complication group, the sensitivity was 53.4%, the specificity was 97.1% and the positive predictive value was 98.6%, the PTM of microangiopathy group was higher than that of macroangiopathy group (P <0.01), the sensitivity was 71.2%, the specificity was 97.1%, and the positive predictive value was 97.9%. Compared the acute stage with restoration stage in stroke, pre-chemotherapeutics with post-operation in AL and MM, and pre-operation with post-operation in cancer, the PTM was connected with clinical development.

Conclusion: PTM was a good criterion in evaluating the microangiopathy in clinical application. PTM was also a valuable index in prediction or assessment of the severity of diseases or in the observation of therapeutic effectiveness.