静脉血栓栓塞症生物标志物的研究进展与临床应用

Advances in biomarkers for venous thromboembolism: research progress and clinical applications

摘要:

静脉血栓栓塞症（VTE）包括深静脉血栓形成和肺血栓栓塞症，是临床常见且可危及生命的血管疾病。尽管D-二聚体已广泛应用于VTE筛查，但其特异度有限，难以满足精准诊断及风险评估需求。近年来，多种新型生物标志物在VTE早期诊断、危险分层、疗效监测及预后预测中的价值不断受到关注。本文围绕D-二聚体、血清微小核糖核酸、组织因子通路抑制剂、中性粒细胞胞外诱捕网、纤维蛋白单体、血栓调节素、微粒、缺血修饰白蛋白、E/P-选择素及半乳糖凝集素-3等生物标志物，综述其生物学功能、作用机制及临床应用进展，并分析多标志物联合检测策略的发展现状与应用前景。未来，建立标准化检测体系，推动多标志物联合评估及多组学整合分析，有望进一步提高VTE的早期诊断能力，实现精准风险分层和个体化治疗。

Abstract:

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary thromboembolism (PE), is a common and potentially life-threatening vascular disease. Although D-dimer is widely used for VTE screening, its limited specificity restricts its diagnostic accuracy and clinical utility for risk stratification. In recent years, increasing evidence has demonstrated that a variety of emerging biomarkers may contribute to the early diagnosis, risk assessment, therapeutic monitoring, and prognostic evaluation of VTE. This review summarizes the biological characteristics, molecular mechanisms, and clinical applications of representative biomarkers, including D-dimer, microRNAs, tissue factor pathway inhibitor, neutrophil extracellular traps, fibrin monomer, thrombomodulin, microparticles, ischemia-modified albumin, E-/P-selectins, and galectin-3. The current progress in multimarker combination strategies and their potential clinical applications are also discussed. Future studies should focus on standardized detection methods, prospective validation of multimarker panels, and integration with multi-omics technologies to improve early diagnosis, individualized risk stratification, and precision management of VTE.