血浆vWF:Ag﹑D-D﹑PIC和AT-Ⅲ:A检测在风湿性心脏病中的应用  

Application of plasma vWF:Ag,D-D,PIC and AT-Ⅲ:A detection in rheumatic heart disease

作　　者：程永红[1] 吉茂礼 Cheng Yonghong;Ji Maoli(Department of Laboratory,The Central Hospital of Shangluo City(Shangluo 726000))

机构地区：[1]陕西省商洛市中心医院检验科,商洛726000

出　　处：《陕西医学杂志》2018年第8期1078-1080,共3页Shaanxi Medical Journal

摘　　要：目的:探讨血浆血管性血友病因子抗原(vWF:Ag)﹑D-二聚体(D-D)﹑抗凝血酶-Ⅲ活性(AT-Ⅲ:A)和纤溶酶-抗纤溶酶复合物(PIC)检测在风湿性心脏病血栓形成中的临床应用。方法:检测62例风湿性心脏病患者的血浆vWF:Ag﹑D-D﹑PIC水平和AT-Ⅲ:A(血栓组30例,无血栓组32例)。同时设立对照组,比较分析以上指标在血栓形成中的变化。结果:风湿性心脏病血栓组和无血栓组vWF:Ag﹑D-D和PIC水平明显高于对照组,而AT-Ⅲ:A明显低于对照组;血栓组的vWF:Ag﹑D-D和PIC水平与无血栓组比较显著增高,而AT-Ⅲ:A则显著降低。以上结果比较差异均有统计学意义(F=78.6,89.3,69.2,67.3,P<0.01)。血浆D-D分别在血栓组和无血栓组中的水平与vWF:Ag、PIC和AT-Ⅲ:A具有相关性(r=0.839,0.863,-0.829,P<0.01),(r=0.799,0.813,-0.782,P<0.01)。ROC曲线分析显示,vWF:Ag﹑D-D﹑PIC水平和AT-Ⅲ:A对诊断风心病血栓的形成AUC分别为0.853(95%CI:0.764~0.943,P<0.01);[0.835(95%CI:0.736~0.935,P<0.01);0.893(95%CI:0.820~0.966,P<0.01);0.908(95%CI:0.829~0.987,P<0.01)]。结论:检测风湿性心脏病患者血浆vWF:Ag、D-D、PIC水平和AT-Ⅲ:A可用于判断患者的凝血活性和体内的纤溶状态,预测血栓发生的危险程度.Objective:To investigate the clinical application of vWF:Ag,D-dimer,AT-Ⅲ:A and PIC Detection in thrombosis for rheumatic heart disease.Methods:Plasma vWF:Ag,D-dimer,PICand AT:A were measured in 62 patients with rheumatic heart disease(30 patients in thrombosis group and 32 patients in non-thrombosis group).At the same time,a healthy control group was set up to compare and analyze the above indexes in thrombosis.Results:The levels of vWF:Ag,D-dimer and PIC in patients with rheumatic heart disease were significantly higher than those in controls,while AT-Ⅲ:A was significantly lower than that in control group,the differences were statistically significant.The levels of vWF:Ag,D-dimer,PIC and PAI-1 in thrombosis group were significantly higher than those in thrombosis group,while AT-Ⅲ:A was significantly decreased,the differences were statistically significant(F=78.6,99.3,69.2,67.3,P<0.01).The levels of vWF:Ag,PIC and AT-Ⅲ:A between thrombosis group and non-thrombosis group were correlated(r=0.839,0.863,-0.829,P<0.01),(r=0.799,0.813,-0.782,P<0.01).ROC curve analysis showed that AUC of vWF:Ag,D-dimer,PIC and AT-Ⅲ:A were,respectively,0.853(95%CI:0.764~0.943,P<0.01);[0.835(95%CI:0.736~0.935,P<0.01);0.893(95%CI:0.820~0.966,P<0.01);0.908(95%CI:0.829~0.987,P<0.01)].Conclusion:Plasma vWF:Ag,D-dimer,PIC levels and AT-Ⅲ:A in patients with rheumatic heart disease can be used to determine the coagulation activity and fibrinolytic status in patients,and to predict the risk of thrombosis.

关 键 词：风湿性心脏病 血栓形成 抗凝血酶Ⅲ 组织型纤溶酶原激活物 嘧啶二聚体 

分 类 号：R541.2[医药卫生—心血管疾病]