下肢深静脉血栓形成患者血浆抗凝蛋白水平检测的临床意义

Clinical significance of plasma anticoagulant proteins in patients with deep venous thrombosis in lower limb

目的：探讨下肢深静脉血栓形成（LDVT）患者的发病机制，研究抗凝血酶（AT）、蛋白S（PS）、蛋白C（PC）、活化蛋白C抵抗性（APCR）在LDVT患者中的变化。方法：用ACL Putum型全自动血凝仪检测LDVT患者100例（初发、复发患者各73、27例）和健康者100例的AT、PS、PC活性及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，差异有统计学意义（P〈0．01～0．001）；100例LDVT患者中，25例有抗凝蛋白缺陷，以PS缺陷的总发生率最高，占13％（13例），其次是PC缺陷，占8％（8例），AT缺陷占5％（5例），APCR缺陷的总发生率最小，占4％（4例）。结论：先天性或获得性抗凝蛋白缺陷是LDVT发病和复发的重要机制之一。

Objective： To investigate the incidence of anticoagulant protein deficiency in Chinese patients with deep vein thrombosis in lower limb. Methods： Molecular markers of anticoagulant proteins were assayed in 100 patients with deep venous thrombosis in lower limb（LDVT） and 100 normal controls with respect to the activity of antithrombin（AT）, protein C（PC）, protein S（PS） and the incidence of activated protein C resistance（APCR）. Results： Between the LDVT group and normal group, there were significant differences in the activity of AT, PC, PS and APCR （ P 〈 0.01 - 0. 001 ）. Of all patients, twenty-five were found to be abnormal, including 13 PS deficiencies, 8 PC deficiencies, 5 AT deficiencies and 4 APCR deficiencies. Conclusion： In this study, the anticoagulation protein deficiencies are frequent in Chinese LDVT patients （both congenital and acquired）, suggesting the etiology of thrombophilia may be different between Chinese and Western.