多器官功能不全综合征患者血浆中VWF、FⅧ和AT-Ⅲ变化的临床意义

Changes of von willebrand factor,Ⅷ factor and Antithrombin Ⅲ in patients with multiple organ dysfunction syndrome

目的:研究多器官功能不全综合征(MODS)患者血管性血友病因子(VWF)、Ⅷ因子(FⅧ)和抗凝血酶-Ⅲ(AT-Ⅲ)的变化,并探讨其临床意义。方法:40例MODS患者被列为观察对象。测定血浆VWF、ⅧF和AT-Ⅲ水平,同时计算患者的急性生理和慢性健康评分(APACHEⅡ)。20例健康者为正常对照。结果:MODS组血浆VWF和FⅧ水平明显高于正常对照组,AT-Ⅲ水平低于正常对照,P<0.01;MODS组中,死亡组血浆VWF和FⅧ水平明显高于生存组,差异有统计学意义,P值分别为P<0.01和P<0.05。MODS患者血浆VWF和FⅧ与APACHEⅡ评分呈正相关,r分别为0.716和0.705,AT-Ⅲ与APACHEⅡ评分呈负相关,r=-0.752,P<0.01。结论:VWF、FⅧ和AT-Ⅲ在MODS的发病过程中起着重要的作用,并与MODS患者病情严重程度相关,可以作为反映MODS患者预后的指标。

Objective To observe the changes of von willebrand factor (VWF),Ⅷfactor(FⅧ) and antithrombin Ⅲ(ATⅢ) in patients with multiple organ dysfunction dysfunction syndrome(MODS)Methods Forty patients with MODS(group MODS) in intensive care unit(ICU),including 26 of survial(group S) and 14 of death(group D) were studied,in which the VWF,Ⅷfactor,ATⅢand APACHE Ⅱscore were measuredTwenty health volunteers were taken as control(group C)Results The plasma concentrations of VWF and FⅧin patients with MODS were significantly higher than those in control group(P< 001),but the plasma concentrations of ATⅢwere significantly lower than those in control groupCompared with group S,the plasma concentrations of VWF and FⅧin group D were significantly increased while the ATⅢlevel decreased(P< 001 and 005)The plasma concentrations of VWF and FⅧwere positive correlation with APACHE Ⅱscore(r=0716 and 0705,respectively,P< 001)The plasma concentrations of ATⅢwere negative correlation with APACHE Ⅱscore(r=-0752,P< 001)Conclusions The VWF,FⅧand ATⅢmay play important roles in pathogenesis of MODS,and be correlation with the degree of MODSIt is suggested that they may be of importance in predicting the prognosis of patients with MODS