蛋白C、蛋白S、活化蛋白C抵抗与缺血性脑血管病的相关性研究

The relation among protein C,protein S, and actived protein C resistance in ischemic cerebrovascular diseases

目的 研究蛋白C(PC)、蛋白S(PS)、活化蛋白C抵抗 (APCR)与急性缺血性脑血管病间的关系。方法 对 80 4例急性脑血管患者及 16 8例非脑血管病患者行PC、PS、APCR检测。结果 在缺血性卒中组PC、PS活性分别为 (115 .8± 12 .5 ) %和 (112 .6± 13.8) % ,明显低于出血性卒中组的 (119.2± 11.3) %和 (112 .1± 16 .5 ) %及对照组的 (12 0 .2± 12 .8) %和 (12 2 .4± 15 .8) % (P <0 .0 1)。进一步比较发现 ,<4 5岁的缺血性卒中组的PC、PS分别为 (5 4 .6 7± 8.9) %和 (40 .4 9± 9.1) % ,明显低于其他各组 ,PS在 4 5岁以上的缺血性卒中组为 (119.2± 15 .6 ) % ,明显低于对照组的 (12 2 .4± 15 .8) % ,(P <0 .0 1) ,其余各组间无显著差异。APCR总发生率 6 .6 % (6 4 / 972 ) ,其中缺血性卒中组为 7.14 % (46 / 6 4 4 ) ,出血性卒中组为 6 .2 5 % (10 /16 0 ) ,两组比较无明显差异 (P >0 .0 5 ) ,4 5岁以下缺血性卒中组APCR的发生率为 4 6 .3% (2 5 / 5 4 ) ,明显高于其他各组。结论 PC、PS活性降低 ,APCR是缺血性脑血管病发生的重要因素 ,特别与 4 5岁以下的缺血性卒中的发生密切相关。

Objective To explore the relations among protein C(PC), protein S(PS), and actived protein C resistance (APCR) in acute ischemic cerebrovascular diseases (AICVD).Methods In 804 cases of acute cerebrovascular disease (ACVD) and 168 cases of non ACVD patients, we tested the PC, PS, and APCR.Results The levels of PC and PS in the AICVD group were ( 115.8 ± 12.5 )% and ( 112.6 ± 13.8 )% respectively, which were significantly lower than those of hemorrhagic stroke group (HSG) ( 119.2 ± 13.3 )% and ( 121.1 ± 16.5 )% and the control group (CP) [( 120.2 ± 12.8 )% and ( 122.4 ± 15.8 )%]( P < 0.01 ).With further comparision, we found the levels of PC and PS in AICVD patients younger than 45 years were ( 54.67 ± 8.9 )% and ( 40.49 ± 9.1 )% respectively, which were significantly lower than those of other groups.The level of PS in the HSG was ( 119.2 ± 15.6 )%, which was significantly lower than that of the CP [( 122.4 ± 15.8 )%]( P < 0.01 ).There was no significant difference among other groups.The total rate of APCR was 6.6% , which were 7.14% and 6.25% in the ischemic stroke group and HSG( P > 0.05 ).The positive rate of APCR in the ischemic stroke patients younger than 45 years was 46.3% , which was significantly higher than those of other groups.Conclusions The decrease of PC and PS levels and positive APCR are the important factors of AICVD, which is close related to the onset of AICVD patients younger than 45 years.