血栓性疾病患者血小板相关组织因子水平及活性改变的意义  

The changes in protein content and procoagulantory activity of platelet-associated tissue factor in thrombotic diseases

作　　者：黄细莲[1] 陈方平[1] 杜建伟[1] 余保军[2] 胡珏[3] 邓满香[4] 

机构地区：[1]中南大学湘雅医院血液科,长沙410008 [2]中南大学湘雅医院心内科,长沙410008 [3]中南大学湘雅医院神经内科,长沙410008 [4]中南大学湘雅医院老干科,长沙410008

出　　处：《中华内科杂志》2005年第8期585-587,共3页Chinese Journal of Internal Medicine

摘　　要：目的探讨血栓性疾病中血小板相关组织因子(TF)蛋白水平和活性的变化及其意义。方法采用Sepharose2B凝胶柱分离纯化血小板,ELISA法测定洗涤血小板破碎液TF蛋白含量;一期血浆凝固时间测定血小板相关TF促凝活性。结果正常人静息血小板TF蛋白(16·37±6·39)ng/L,未活化的血小板促凝活性为(0·89±0·26)U/ml,胶原活化后的血小板促凝活性为(2·27±0·24)U/ml,加入特异性TF单抗后活性为(1·39±0·28)U/ml,活化血小板的活性能被TF单抗显著抑制(P<0·001),证明活化后血小板的促凝活性主要来自TF。血栓性疾病中冠心病组、脑梗死组、糖尿病组血小板破碎液中TF蛋白水平分别为(20·71±8·78)、(23·83±8·03)、(22·12±8·24)ng/L,其对应的未经胶原处理的血小板促凝活性分别为(1·71±0·24)、(1·69±0·25)、(1·75±0·31)U/ml,加入TF单抗后分别为(1·43±0·25)、(1·39±0·25)、(1·40±0·29)U/ml,血栓性疾病患者血小板破碎液中TF蛋白水平及活性均较正常对照明显增高,其促凝活性可被TF单抗显著抑制(P<0·01)。结论血栓性疾病中血小板相关TF的变化可能参与了疾病过程中高凝状态的形成。Objective To explore the change in the protein content and procoagulant activity of platelet-associated tissue factor （TF） in thrombotic diseases. Methods Platelets were isolated with Sepharose 2B gel column. ELISA was employed to detect the TF protein content in the lysates of washed platelets,procoagulant activity of platelet-associated TF was measured with one stage clotting time assay. Results A certain amount of TF antigen （16. 37±6.39） ng/L was detected in resting platelets in normal controls. The procoagulant activity of resting platelets and platelets activated by collagen were （0.89±0.26） ,（2.27±0.24）U/ml respectively. While specific TF McAb was added , the procoagulant activity of activated platelets can be markedly inhibited（1.39±0. 28）U/ ml （P〈0.001）. It is thus proved that the procoagulant activity of activated platelets mainly comes from TF. TF protein content of the lysates of washed platelets in coronary heart disease group, brain infarction group and diabetes mellitus group was （20. 71±8.78）, （23.83±8.03 ）, （ 22. 12±8. 24） ng/L respectively. The procoagulant activity of platelets without collagen treatment in these thrombotic diseases was（1.71±0. 24）, （ 1.69±0. 25）, （ 1.75±0. 31）U/ ml respectively. When specific TF McAb was added specific TF McAb, the procoagulant activity was （ 1.43±0. 25）, （ 1.39±0. 25 ）, （ 1.40±0. 29 ） U/ ml respectively, The TF protein content of lysates of washed platelets and the procoagulant activity of platelets without collagen treatment in patients with thrombotic diseases were significantly higher than those in normal controls. This procoagulant activity can be inhibited by TF McAb （ P〈0. 01 ）. Conclusion The change in platelet-associated TF in thrombotic diseases may contribute to the maintenace of hypercoagulability.

关 键 词：血管疾病 血小板 血栓形成 凝血致活酶 洗涤血小板 血栓性疾病 活性改变 蛋白水平 组织因子 疾病患者 

分 类 号：R55[医药卫生—血液循环系统疾病]