TAFI与PAI-1及t-PA水平与系统性红斑狼疮患者下肢深静脉血栓形成的关系  

Relationship between plasma levels of thrombin activatable fibrinolysis inhibitor, plasminogen activator inhibitor-1 and tissue-type plasminogen activator and deep venous thrombosis in patients with systemic lupus erythematosus

作　　者：刘一帆[1] 侯楠 石颜军[1] 李春先[1] 高艳军 刘立宁[1] Liu Yifan;Hou Nan;Shi Yanjun;Li Chunxian;Gao Yanjun;Liu Lining(Department of Rheumatology and Immunology,Liaocheng People′s Hospital of Shandong Province,Liaocheng 252000,China;Department of Laboratory Medicine,Liaocheng People′s Hospital of Shandong Province,Liaocheng 252000,China)

机构地区：[1]山东省聊城市人民医院风湿免疫科,聊城252000 [2]山东省聊城市人民医院检验科,聊城252000

出　　处：《中华医学杂志》2023年第21期1638-1642,共5页National Medical Journal of China

摘　　要：目的探讨系统性红斑狼疮(SLE)患者血浆凝血酶激活纤溶抑制物(TAFI)、纤溶酶原激活物抑制剂(PAI-1)及组织型纤溶酶原激活物(t-PA)水平,以及其与下肢深静脉血栓形成的关系。方法本研究采用病例对照研究方案,回顾性选取山东省聊城市人民医院2018年6月至2021年6月收治的发生下肢深静脉血栓的SLE患者32例(血栓组),其中男4例,女28例,年龄(49.7±5.5)岁;选取同期未发生下肢深静脉血栓的SLE患者64例(对照组),其中男11例,女53例,年龄(50.8±5.5)岁。比较两组患者血浆TAFI、PAI-1及t-PA水平,多因素分析采用logistic回归模型,分析其与SLE患者下肢深静脉血栓形成的关系。结果血栓组SLE患者血浆TAFI、PAI-1、t-PA水平分别为(32.77±5.17)mg/L、(29.43±5.51)μg/L、(6.58±1.40)μg/L,对照组分别为(23.56±4.40)mg/L、(19.00±4.40)μg/L、(9.40±2.23)μg/L,血栓组TAFI、PAI-1水平高于对照组,t-PA水平低于对照组(均P<0.05)。logistic回归模型结果显示,TAFI水平增高(OR=1.75,95%CI:1.05~2.90,P=0.043)、PAI-1水平增高(OR=1.85,95%CI:1.04~3.29,P=0.046)、t-PA水平降低(OR=0.72,95%CI:0.52~0.99,P=0.048)是SLE患者下肢深静脉血栓形成的相关因素。结论血栓组SLE患者血浆TAFI、PAI-1水平增高,t-PA水平降低,并且是SLE患者并发下肢深静脉血栓形成的相关因素。Objective To investigate the plasma levels of thrombin activatable fibrinolysis inhibitor(TAFI),plasminogen activator inhibitor-1(PAI-1)and tissue-type plasminogen activator(t-PA)in patients with systemic lupus erythematosus(SLE),and their relationship with deep venous thrombosis of the lower limbs.Methods A case-control study was conducted to retrospectively select 32 SLE patients with deep venous thrombosis of the lower extremities(thrombus group)admitted to Liaocheng People′s Hospital in Shandong Province from June 2018 to June 2021,including 4 males and 28 females,with a mean age of(49.7±5.5)years.Meanwhile,64 SLE patients without deep venous thrombosis of the lower extremities(control group)were also selected,including 11 males and 53 females,with a mean age of(50.8±5.5)years.The plasma levels of TAFI,PAI-1 and t-PA of the two groups were compared.A logistic regression model was used to analyze the correlation of TAFI,PAI-1 and t-PA with SLE in patients.Results The plasma levels of TAFI,PAI-1 and t-PA were(32.77±5.17)mg/L,(29.43±5.51)μg/L and(6.58±1.40)μg/L in the thrombotic group,while the plasma levels of TAFI,PAI-1 and t-PA in the control group were(23.56±4.40)mg/L,(19.00±4.40)μg/L and(9.40±2.23)μg/L.The levels of TAFI and PAI-1 in the thrombotic group were higher than those in the control group,while the level of t-PA was lower than that in the control group(all P<0.05).The results of logistic regression model showed that higher TAFI levels(OR=1.75,95%CI:1.05-2.90,P=0.043),higher PAI-1 levels(OR=1.85,95%CI:1.04-3.29,P=0.046),and lower t-PA levels(OR=0.72,95%CI:0.52-0.99,P=0.048)were related factors for the occurrence of deep venous thrombosis of the lower limbs in SLE patients.Conclusion The plasma levels of TAFI and PAI-1 in SLE patients with deep venous thrombosis of the lower extremities increase,while the t-PA level decreases,which are related factors for the occurrence of deep venous thrombosis of the lower extremities in SLE patients.

关 键 词：红斑狼疮 系统性 凝血酶 纤溶抑制物 纤溶酶原激活物抑制剂 组织型纤溶酶原激活物 下肢深静脉血栓 

分 类 号：R593.241[医药卫生—内科学] R543.6[医药卫生—临床医学]