血栓性疾病患者抗凝蛋白检测的临床意义  

Clinical significance of anticoagulant proteins detection in patients with thrombotic events

作　　者：郑昌成[1] 吴竞生 丁凯阳[1] 李洁[2] 胡何杰[3] 丁小玲[4] 刘欣[1] 蔡晓燕[1] 朱薇波[1] 

机构地区：[1]安徽医科大学附属安徽省立医院血液内科,合肥230001 [2]安徽医科大学附属安徽省立医院检验科,合肥230001 [3]安徽医科大学附属安徽省立医院血管外科,合肥230001 [4]安徽医科大学附属安徽省立医院神经内科,合肥230001

出　　处：《中华血液学杂志》2009年第4期264-267,共4页Chinese Journal of Hematology

基　　金：安徽省临床医学重点学科应用技术项目（05A018）

摘　　要：目的探讨血栓性疾病患者蛋白C（PC）、蛋白S（PS）和抗凝血酶（AT）活性水平检测在排除常见获得性血栓危险因素中的临床意义。方法检测85例血栓性疾病患者与50名正常健康对照者血浆PC、PS、AT活性水平，并作比较分析。结果85例血栓性疾病患者中位年龄42（17～69）岁，其中≤45岁者60例（70．6％）。动脉血栓组和静脉血栓组患者PC、PS、AT活性均明显低于正常对照组（P〈0．01）；复发组PC、PS、AT平均活性低于初发组（P〈0．01）；年龄≤45岁患者组PC、PS、AT平均活性低于45岁以上组（P〈0．01）。共有26例（30．6％）患者存在抗凝蛋白活性降低；PS活性降低的发生率最高（10．6％），其次为PC活性降低（8．2％），AT活性降低和联合活性降低（各占5．9％）。结论无明确常见获得性血栓危险因素的血栓患者发病年龄较轻，且普遍存在抗凝蛋白水平低下；抗凝蛋白活性降低不仅与血栓性疾病的发生有关，而且与血栓复发密切相关。Objective To investigate the prevalence and the risk of natural anticoagulants such as plasma protein C （ PC）, protein S （PS） and antithrombin （AT） deficiency in thromboembolic patients with no evident acquired factors. Methods Clotting assays on French STAGO autoanalyzer were used to detect the activity of plasma PC, PS and AT in 85 patients with thrombotic disease and 50 sex and age matched healthy controls. Results Among the 85 enrolled patients （ 18 arterial and 67 venous thromboembolism）, male to female ratio was 1.4 and the median age was 42 years （ 17 - 69）. The activity of plasma PC,PS and AT in the pre-therapy thrombotic disease group, the thrombo-recurrence group, and the age ≤45 years group were sig- nificantly lower than that is the healthy control group, the first thrombotic episodes group and the age 〉 45 years group respectiyely （ P 〈 0. 001, P 〈 0.01, P 〈 0.01 ）. The ouerall deficiency rale of these three natural anticoagulants was 30. 6%, PS deficiency was the commonest （ 10. 6% ）, the second was PC deficiency （8.2%）, AT deficiency and combined deficiency each accounted for 5.9%. Conclusion The PC, PS and AT protein deficiencies are frequent in Chinese thromboembolic patients, they are the independent risk factors for the thrombotic events and recurrence.

关 键 词：血栓形成 蛋白质C 蛋白质S 抗凝血酶类 危险因素 

分 类 号：R686[医药卫生—骨科学]