冠心病患者活化蛋白C敏感率及抵抗现象的研究  

Study on activated protein C sensitivity ratio and activated protein C resistance in patients with coronary heart disease

作　　者：何文娟[1] 胡豫[1] 张小平[1] 魏文宁[1] 郭涛[1] 洪梅[1] 宋善俊[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院血液科湖北省生物靶向治疗重点实验室,湖北武汉430022

出　　处：《中国实用内科杂志》2007年第20期1602-1604,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家卫生部基金(2004468)

摘　　要：目的检测冠心病(CHD)患者活化蛋白C敏感率(APC-SR)并计算活化蛋白C抵抗(APCR)阳性率,探讨APC-SR及APCR在CHD中的临床意义。方法选取2006年1月至7月华中科技大学同济医学院附属协和医院心内科住院的56例CHD患者为研究对象,对照组为同期在本院耳鼻喉科住院的患者54例,采用全自动血凝分析仪测定APC-SR,计算APCR阳性率;同时采用免疫酶联吸附试验检测血浆中蛋白C、总蛋白S和游离蛋白S。结果CHD患者APC-SR平均值(2.44±0.18)显著低于对照组(2.68±0.15)(P<0.01);CHD组APCR阳性率与对照组比较,差异无显著性意义。CHD组APC-SR<2.4的阳性率显著高于对照组(P<0.01)。蛋白C、总蛋白S和游离蛋白S在CHD组和对照组之间差异无显著性意义。结论低水平APC-SR与CHD的发病相关,可考虑将该指标作为CHD危险人群的筛查指标。Objective To detect activated protein C sensitivity ratio（APC-SR）and prevalence of activated protein C resistance（APCR） in patients with coronary heart disease （CHD）so as to investigate clinical significance of APC-SR and APCR for CHD. Methods Fifty-six patients with coronary heart disease admitted to Department of Cardiology and 54 controls excluded thromboembolic disease, diabetes mellitus and hypertension in Wuhan Union Hospital from January to July 2006 were enrolled. Coronary artery disease group and control group were matched for age, sex and sampling time. APC-SR was measured by full-automated coagulation analyzer（ Sysmex CA-7000 ,Japan）and then prevalence of APCR was calculated,plasma levels of protein C, free protein S and total protein S were detected by enzyme-linked immunosorbent assay （ELISA）. Results The average APC-SR of C HD patients was significantly lower than that of controls （2.44 ±0.18 versus 2.68 ± 0.15 ,P〈0.001 ） ;there were no significant differences in prevalence of APCR, protein C, free protein S and total protein S between the two groups, and the prevalence of an APC-SR below 2,4 was 39.3% in CHD group, which was significantly higher than that of controls （P〈0.01）. Conclusion It is suggested that there is a relationship between low APC-SR and CHD,and APC-SR could be considered as a screening factor for CHD.

关 键 词：冠状动脉疾病 活化蛋白C抵抗 蛋白C 蛋白S FV LEIDEN突变 

分 类 号：R5[医药卫生—内科学]