地中海贫血患者组织因子微粒促凝活性及抗凝血酶Ⅲ检测的意义  

Significance of Tissue Factor-Bearing Microparticle Procoagulation Activity and Antithrombin Ⅲ Detection in Thalassemia Patients

作　　者：苏谐 刘徽 孙娜[1] 程鹏[1] 邓东红[1] 龙媛[1] SU Xie;LIU Hui;SUN Na;CHENG Peng;DENG Dong-Hong;LONG Yuan(Department of Hematology,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Gucmgxi Zhuang Autonomous Region,China)

机构地区：[1]广西医科大学第一附属医院血液内科,广西南宁530021

出　　处：《中国实验血液学杂志》2019年第2期539-544,共6页Journal of Experimental Hematology

基　　金：国家自然科学基金(81660025);广西自然科学基金(2016JJA140350)

摘　　要：目的:通过检测地中海贫血患者血浆组织因子微粒(TF+MP)的促凝活性、凝血及抗凝物、纤溶功能、内皮细胞功能及血小板(Plt)计数,探讨广西地区地中海贫血患者是否存在可能引起血液高凝状态及血栓形成的高危因素。方法:对71例地中海贫血组及20例正常对照组分别用发色底物法检测血浆TF+MP促凝活性,ELISA法检测血浆组织因子(TF)、组织因子途径抑制物(TFPI)、蛋白C(PC)、蛋白S(PS)、抗凝血酶Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物(t-PA)、凝血酶激活的纤溶抑制物(TAFI)、可溶性E选择素(sE-sel)、细胞间粘附分子-1(sICAM-1)、血栓调节蛋白(sTM)水平。结果:重型β地中国贫组(TM组)AT-Ⅲ水平较对照组降低(P <0.05),TM组AT-Ⅲ与Plt计数成独立正相关(rPLT=0.37,P <0.05);中间型α地中海贫血组(TA组)TF及sICAM-1水平较对照组显著降低(P <0.01);中间型β地中海贫血组(TI组)血浆TF+MP促凝活性较对照组显著增高(P <0.05)并与AT-Ⅲ呈独立正相关(rAT-Ⅲ=0.77,P <0.05)。地中海贫血患者肝功能正常组TF及sICAM-1水平较对照组降低(PTF<0.01,PsICAM-1<0.05),肝功正常组与非正常组间TF+MP活性有显著性差异(P <0.05);其余各组相应指标与对照组相比及组间相比无显著性差异。结论:广西重型β地中海贫血患者有肝功能损害及抗凝物质的减少;中间型β自中海贫血患者血浆TF+MP的促凝活性异常增高;以上因素可能增加地中海贫血患者血液高凝状态或血栓形成的风险,但中间型α地中海贫血患者血浆sICAM-1及TF水平降低可能是中间型α地中海贫血患者及肝功正常患者抗血栓形成的保护性因素。Objective:To explore whether the high risk factors possibly leading to hypercoagulative status and thrombosis exist in Thalassemia patients of Guangxi region through detecting plasma tissne factor-bearing microparticles(TF^+MP),procoagulatima activity,coagulation and anticoagulation function,fibrinolytic function,endothelial function and platelet count.Methods:The TF^+MP procoagulation activity was detected by chromogenic saubstract method,the levels of tissue factors(TF),tissue factor pathway inhibitor(TFPI),protein C(PC),protein S(PS),antithrombin Ⅲ(AT-Ⅲ),tissue plasminogen activator(tPA),thrombin-activated fibrinolysis inhibitor(TAFI),soluble E-selectin(sE-sel),intercellular adhesion molecule-1(ICAM-1)and thrombomodulin(TM)were detected by ELISA in thalassemia group(n=71)and control group(n=20 heathy persons).Results:Compared with control group,the AT-Ⅲ level decreased in β-thalastemia major group(TM)(P<0.05),the AT-Ⅲ level in TM group independeutly posstiody correlated with plt count(r=0.37,P<0.05);the levels of TF and sICAM in α-thalassenia intermediate group(TA)significantly decteased(P<0.05),the procoagulatim activity of TF^+MP in β-thalassemia intermediate group(TI)increased sngnificantly(P<0.05),moreover positively corretated with AT-Ⅲ level(r=0.77,P<0.05).The TF and sICAM-1 levels in normal liver functim group of Thalassemia patients were lower tham those in control group(P<0.01 and P<0.05,respectively),the TF^+MP activity between normal and abnormal liver function was significantly different(P<0.05),while there were no significant difference in other correspoding indexes beween thalassemia group and control group as well as between each thalassemia groups.Conclusion:The damage of liver function and reduction of anticoagylation substances exist in patients withβ-thalassenia major in Guangxi region,the procoagulation activity of plasma TF^+MP in patients with β-thalassemia intermedia abnormally increases.All the above-mentioned factors may increase the risk of high coagulation status or th

关 键 词：地中海贫血 组织因子微粒 组织因子 抗凝血酶Ⅲ 细胞间粘附分子-1 

分 类 号：B556.61[哲学宗教—外国哲学]