个体相关变量对中国健康人群常规凝血参数的影响  

Effects of individual-related variables on routine coagulation parameters in apparent healthy Chinese adults

作　　者：李建新[1,2] 黄燕清[2] 聂李平[2] 周宇[2] 颜存粮[2] 任汉云[1] 

机构地区：[1]北京大学第一医院血液科,北京100034 [2]北京大学深圳医院检验科,广东深圳518036

出　　处：《诊断学理论与实践》2010年第1期42-47,共6页Journal of Diagnostics Concepts & Practice

基　　金：广东省科技计划资助项目(2006B35530007)

摘　　要：目的:本研究旨在建立中国健康人群年龄和性别相关的常规凝血试验参考范围,并评估吸烟、血糖和血压等个体相关因素对其影响。方法:回顾性统计分析2004年5月至2007年10月北京大学深圳医院成人择期非感染小手术患者术前的凝血功能检查资料。结果:1729例患者符合入选标准而被纳入研究,其中,男1104例,女625例。常规凝血参数呈一定程度的年龄和性别依赖。随着年龄增长,纤维蛋白原(Fib)水平逐渐增高,女性显著高于男性;活化部分凝血活酶时间(APTT)逐渐缩短,50岁以上女性APTT显著短于男性;凝血酶原时间(PT)和国际标准化比率(INR)呈现逐渐缩短/降低趋势,但60岁以上有延长趋势。女性TT长于男性。男性吸烟者和非吸烟者比较,INR、APTT和凝血酶时间(TT)显著降低/缩短,Fib显著增高。血压与APTT、TT弱负相关,与Fib弱相关。空腹血糖(FBG)与PT、INR、APTT以及TT弱负相关,与Fib弱相关。逐步多元线性回归分析显示,FBG、年龄、吸烟与中国正常成人APTT值独立负相关。结论:随着年龄增长,血液凝固潜能越来越强,可部分解释随着老化进程动脉和静脉血栓形成发病率呈指数级增加。吸烟、正常范围内的较高FBG水平为促凝因素。本研究建立了大样本中国人年龄和性别相关的常规凝血参数参考范围,可为以后进行年龄跨度较大的相关研究、临床诊断和治疗提供参考。Objective The purpose of this study was to develop age- and gender-related reference intervals of routine coagulation parameters for healthy Chinese population, and to evaluate the effect of individual-related variables, i.e. smoking, blood pressure and fasting blood glucose （FBG） on these parameters. Methods Preoperative routine coagulation parameters in adult patients underwent elective non-infectious minor surgery in Peking University Shenzhen Hospital from May 2004 to October 2007 were retrospectively analyzed. Results A total of 1,729 adults were eligible for this study, including 1,104 males and 625 females. Age- and gender-dependent changes were found in the routine coagulation parameters. With increase in age, plasma fibrinogen （Fib） level was gradually elevated and was significantly higher in females than in males, while activated partial thromboplastin time （APTT） was gradually shortened, and was more shortened in females after 50 years of age. Prothrombin time （PT） and international normalized ratio （INR） decreased gradually before 60 years old, while had a trend of increase after that age. Thrombin clotting time （TT） was longer in females than in males. INR, APTT and TT decreased and Fib increased in male smokers when compared with non- smokers. Blood pressure level correlated weakly and negatively with AP＇IT and TT and weakly with Fib. Fasting blood glucose （FBG） level correlated weakly and negatively with PT, INR, APTT and TT, and weakly with Fib. Stepwise multiple linear regression analysis showed that FBG, age and smoking correlated negatively and independently with APTr in apparent healthy Chinese adults. Condusions Coagulation potential elevates gradually with increase in age, which can explain partly the exponential rise of arterial and venous thromboembolism events in elder people. Smoking and increasing FBG levels in the normal range are procoagulant factors. Age- and gender-related reference intervals of routine coagulation parameters based on a large healthy Ch

关 键 词：常规凝血试验 年龄 性别 吸烟 血压 空腹血糖 

分 类 号：R446.1[医药卫生—诊断学]