深静脉血栓形成患者抗活化蛋白C与抗磷脂抗体相关性分析

Study of antiphospholipid antibodies and activated protein C resistance in patients with deep vein thrombosis

目的:探讨我国深静脉血栓形成(DVT)患者抗心磷脂抗体(ACA)、狼疮抗凝因子(LA)及抗活化蛋白C(APCR)的相关关系。方法:以ELISA法检测ACA(IgG,IgM,IgA);APTT法检测LA;APTT+/-APC法检测APCR;PCR-限制性片断长度多态性方法(PCR-RFLP)检测FVLeiden变异。结果:DVT组患者抗磷脂抗体(APA)、APCR的总阳性率分别为34.7%、5.5%,与对照组比较差异有统计学意义;APA阳性组APCR阳性率(12%)明显高于APA阴性组(2.1%),4例APCR阳性患者中有3例APA阳性,并能被血小板磷脂纠正,未检测到凝血因子Ⅴ(FⅤ)Leiden突变。结论:抗磷脂蛋白抗体及其产生获得性APCR是高凝状态和血栓形成的重要原因。

Objective：To explore the correlation between anticardiolipin antibodies （ACA）, Lupus anticogaulants （LA） and activated protein C resistance （APCR） in Chinese patients with deep vein thrombosis. Method： ELISA, APTT LA and APTT＋/-APC methods were used to detect ACA, LA and APCR, respectively. And factor V gene mutation was examined by polymerase chain reaction with reseriction fragments length polymorphism （PCR-RFLP）. Result：The total positive rates of APA and APCR in DVT group （34.7 %, 5.5 %） were much higher than those in normal control group. The positive rate of APCR （12 %） in patients with APA positive was significantly higher than that （2.1%） in patients with APA negative. APA was positive in 3 of 4 patients with APCR positive, which could be corrected by platelet phospholipid. No factor V leiden gene mutation were found in DVT group. Conclusion： APA and the acquired APCR might be important cause of hypercoagulation states and thrombosis.