三种抗凝蛋白和D-二聚体含量检测及临床意义

Detection of three types of anticoagulant proteins and D-Dimer in plasma and its clinical significance

目的检测不同病因引起弥漫性血管内凝血(DIC)患者血浆中D-二聚体(D-D)含量,及抗凝血酶Ⅲ(AT)、蛋白C(PC)、蛋白S(PS)活性,探讨其临床意义.方法采用法国STAGO公司的全自动血凝分析仪,检测由不同疾病引起DIC的72例患者血浆中D-D含量(免疫比浊法)及AT(发色底物法)、PC(凝固法)、PS(凝固法)活性.结果不同病因引起的DIC患者血浆D-D均明显升高,多数病例组为正常对照组的10～30倍,恶性肿瘤组为正常对照组的近百倍;除白血病组血浆AT与正常对照组无明显差别(P>0.05)外,其余所有DIC病例组的血浆AT、PC、PS均明显降低(P<0.05).结论血浆D-D升高是诊断DIC的敏感指标.在多数病因造成的DIC中,抗凝系统功能降低是病理生理过程的重要环节.

Objective To investigate the plasma level of D-dimer(D-D), antithrombin-Ⅲ (AT), protein C (PC) and protein S (PS) in disseminated intravascular coagulation (DIC) patients with different etiology and to explore its clinical significance.Methods The plasma levels of D-D,AT,PC and PS in 72 DIC cases were determined by STAGO coagulation analyzer.Results Plasma level of D-D was much higher than normal controls, with 10-30 times in most patient groups and nearly 100 times in malignancy patients.Plasma AT, PC and PS were significantly higher than normal controls in all patient groups (P<0.05)except that AT in leukemia group was similar to that of normal controls(P>(0.05).Conclusions Plasma D-D is one of sensitive indicators for diagnosing DIC. Dysfunction of anticoagulation system is prominent in DIC patients with most kinds of etiology.