血栓病患者凝血、抗凝和纤溶活性改变的研究  

Study of changes of procoagulant, anticoagulant and fibrinolysis in patients with thrombosis

作　　者：屈晨雪[1] 夏铁安[1] 王建中[1] 

机构地区：[1]北京大学第一医院检验科,北京100034

出　　处：《中国实验诊断学》2001年第5期222-224,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的　观察血栓病患者凝血、抗凝和纤溶指标的变化 ,以探讨出凝血系统机能紊乱与血栓病发生的关系 ,并在此基础之上为以后临床筛查、确诊血栓病提供依据。方法　应用ACLFutura全自动凝血仪对 50例静脉血栓、51例动脉血栓病患者及 36例正常人进行凝血、抗凝及纤溶系统蛋白分子检测 ,包括凝血因子Ⅱ、Ⅶ、Ⅷ活性测定 ,蛋白C(PC)、蛋白S(PS)、抗凝血酶 (AT)、纤溶酶原 (PLG)、α2 抗纤溶酶 (α2 PI)活性测定 ,D 二聚体、纤维蛋白原含量测定及狼疮抗凝物 (LA)、活化蛋白C抵抗 (APCR)的检测。结果　LA阳性者 ,正常组中有 4例 ,静脉组中有 1 6例 ,动脉组中有 1 3例。PC系统缺陷在静脉血栓病组中 ,共有 1 4例 ,分别为PC缺陷 8例 (1 9 0 % )、PS缺陷 5例 (1 1 5% )、APCR 1例 ;动脉血栓组中 ,PC系统缺陷共 1 1例 ,PC缺陷 2例 ,PS缺陷 7例、APCR 2例。结论　获得性因素LA阳性和PC系统缺陷是引起血栓病的主要原因 ,建议对于血栓患者首选这两项实验进行筛查 。Objective To explore the correlation between incidence of thrombotic diseases and coagulant systems and to set up a serial programs to screen and confirm thrombotic diseases in clinic. Methods We detected the ingredients of procoagulant, anticoagulant, fibrinolysis in 50 patients with venous thrombosis, 51 patients with arterial thrombosis and 36 control subjects, including activity or content determinations of procoagulant factors Ⅱ,Ⅶ,Ⅷ, antithrombin (AT), protein C(PC), protein S(PS), plasminogen (PLG), α 2 antiplasmin (α 2 PI), D Dimer, fibrinogen and detection of lupus anticoagulant(LA), activated protein C resistant(APCR). Results Positive LA patients were 16, 13 and 4 in venous thrombosis group, arterial thrombosis group and control group respectively. In patients with venous thrombosis, 14 patients were detected with defects of PC pathway, including 8 patients with PC defect, 5 patients with PS defect, 1 patient with APCR. In patients with arterial thrombosis, 11 patients were detected with defects of PC pathway, including 2 patients with PC defect, 7 patients with PS defect, 2 patients with APCR. Conclusion Acquired factor LA and defects of PC pathway are two main causes of thrombotic diseases and they should be the first choice determinations for patients with thrombosis.

关 键 词：血栓病 凝血 抗凝 纤溶 

分 类 号：R446.1[医药卫生—诊断学]