蛋白质Z检测在心脑血管疾病中的临床意义

Clinical significance of protein Z alteration in patients with cardio cerebral thrombotic diseases

目的 研究蛋白质Z(ProteinZ ,PZ)在心脑血管疾病中的变化 ,并探讨其临床意义及与血液凝固因子Ⅹ (FⅩ )的关系。方法 PZ及FⅩ∶Ag用ELISA法检测 ,血浆FⅩ∶C采用一期法测定。对 170例急性缺血性脑卒中 (AIS)、4 0例急性心肌梗死 (AMI)、6 0名健康者的PZ、FⅩ∶C、FⅩ∶Ag进行测定及相关性比较 ,同时对初发与再发、不同年龄、不同性别患者PZ、FⅩ∶C、FⅩ∶Ag水平进行比较。结果 AIS组和AMI组的PZ水平分别为 (94 0 .0 2± 2 2 9.82 ) μg/L与 (10 71.4 4± 180 .5 2 ) μg/L ,与对照组 [(2 2 5 7.97± 4 79.76 ) μg/L]相比明显下降 (P值均 <0 .0 0 1)。AIS组的FⅩ∶C、FⅩ∶Ag水平分别为(136 .73± 34.93) %、(135 .5 4± 5 4 .39) % ,AMI组分别为 (139.5 3± 2 9.18) %、(12 9.75± 2 1.91) % ,与对照组 [分别为 (94 .33± 2 0 .0 0 ) %和 (77.2 2± 13.19) % ]相比显著升高 (P值均 <0 .0 0 1)。AIS、AMI组及对照组中的PZ水平与FⅩ∶C、FⅩ∶Ag水平之间均存在明显负相关 (P值均 <0 .0 0 1) ,同时再发AIS、AMI组PZ、FⅩ∶C、FⅩ∶Ag分别与初发组比较 ,有显著性差异 (P值均 <0 .0 5 ) ,显示PZ水平的下降程度反映了疾病的病理过程。PZ水平随年龄增加而下降 (P <0 .0 5 ) ,而FⅩ∶C、FⅩ∶Ag水平与年龄?

Objective To study the alteration of protein Z (PZ) in patients with cardio cerebral thrombotic diseases, its clinical significance and relations with FⅩ. Methods PZ and FⅩ∶Ag were measured by ELISA, and plasma FⅩ∶C by first stage method. In 170 patients with acute ischemic stroke (AIS), 40 acute myocardial infarction (AMI) and 60 healthy adults as contrast, PZ , FⅩ∶C and FⅩ∶Ag were measured and compared between incipience and recurrence, different ages and genders. Results In AIS and AMI groups, PZ levels decreased significantly to (940.02±229.82) μg/L and (1071.44± 180.52 ) μg/L, respectively \[the contrast group was (2257.97±479.76)μg/L,P< 0.001 \]. But FⅩ∶C and FⅩ∶Ag raised to (136.73±34.93)% and (135.54±54.39)% in AIS group; and to (139.53± 29.18 )%, (129.75±21.91)% in AMI group, respectively, while in the contrast group they were (94.33±22.00)% and (77.22±13.19)% (P< 0.001 ). In the comparative research between the AIS group, AMI group and the contrast group, PZ level was clearly found to negatively relate to the level of FⅩ∶C and FⅩ∶Ag (P<0.001). Meanwhile, PZ level, FⅩ∶C and FⅩ∶Ag in recur AIS group and recur AMI group exhibited significant differences (P< 0.05) from those in the primary AIS and AMI groups, suggesting that the decrease of PZ levels reflected the pathological process of the disease. In addition, PZ level gradually decreased with the increase of age(P<0.05), while FⅩ∶C and FⅩ∶Ag had no relations with age (P>0.05 ). No correlation was found in sex with PZ level, FⅩ∶C , FⅩ∶Ag (P>0.05). Conclusion PZ level was significantly decreazed in AIS and AMI patients and was negatively related to FⅩ∶C and FⅩ∶Ag. The mechanism leading to FⅩ increase may partially related with the decreased of PZ. PZ level was different in the primary and recurrent disease and was gradually decreased with the increase of age. Lack of PZ might be a etiological factor of cardio cerebral thrombotic diseases.