下肢深静脉血栓形成患者抗凝蛋白缺陷的临床研究

A Study on the Deficiency of Anticoagulant Proteins in Patients with Deep Vein Thrombosis in Lower Limb

目的:研究中国人群下肢深静脉血栓形成(LDVT)患者抗凝蛋白缺陷的发生率,探讨中国人群LDVT的主要发病机制。方法:应用ACL Puturn型全自动血凝仪检测100例LDVT患者(73例初发,27例复发)和100例健康人的抗凝血酶(AT)、蛋白S(PS)、蛋白C (PC)活性及活化蛋白C抵抗性(APCR)。结果:LDVT组与正常对照组相比、LDVT复发组与初发组相比,AT、PS、PC活性明显降低, APCR阳性率明显升高,均有极显著差异(P<0．01);本组100例LDVT患者中共有25例患者存在有抗凝蛋白缺陷．以PS缺陷的总发生率最高,为13％(13例),其次是PC缺陷,为8％(8例);AT缺陷占5％(5例),APCR缺陷的总发生率最小,为4％(4例)。结论:先天性或获得性抗凝蛋白缺陷是中国人LDVT发病和复发的重要机制之一,因此有必要对LDVT患者进行抗凝蛋白水平的筛选。

Objective： To investigate the Prevalence of anticogulant proteins deficiency in patients with lower limb deep vein thrombosis in China. Methods： Molecular markers of anticoagulant proteins were assayed in 100 patients with deep venous thrombosis in lower limb and 100 healrhy controls. Lndex parameters include： the level of Antithrombin（AT ）, the activity of Protein C（PC）, the activity of Protein S （PS） ,the incidence of activated protein C resistance（APCR）. Results： Between the LDVT group and healthy group, and between the recurrent patients and the newly diagnosed patients ,there were significant differences in the activity of AT, PC, PS and APCR （P〈0. 01） respectively;Of all patients twenty-five were found to be abnormal, including PS deficiencies, 8 PC deficiencies, 5 AT deficiencies and 4 APCR deficiencies. Conclusion：The resuts of this study suggest that the anticoagulation protein deficiencies are frequent in Chinese LDVT patients （both congenital and acquired）. The overall prevalence of AT, PC, PS deficiency in Chinese was higher than that of Western patients, ,Which suggestsed that the etiology of thrombophilia be different between Chinese and Western population.