血浆血栓调节蛋白检测的临床应用

Clinical application of plasma thrombomodulin measurement

目的探讨血栓调节蛋白（ＴＭ）作为血管内皮损伤的分子标志物在临床检测中的意义。方法采用ＥＬＩＳＡ方法测定急性白血病（ＡＬ）、糖尿病（ＤＭ）和肝脏疾病患者的血浆ＴＭ浓度。结果①ＡＬ组血浆ＴＭ水平比正常组显著升高。急性非淋巴细胞性白血病（ＡＮＬＬ）组与急性淋巴细胞性白血病（ＡＬＬ）组间无明显差异；缓解后ＡＬ组较治疗前显著下降。②ＤＭ组血浆ＴＭ水平比正常组明显升高。微血管病变组又高于无微血管病变组。③肝脏疾病患者除急性肝炎组外，血浆ＴＭ水平皆较正常对照组显著升高，其中急性重症肝炎组显著高于急性肝炎组，肝硬化失代偿组显著高于代偿组。结论血浆ＴＭ水平的测定对预示疾病的转归具有临床意义。

bjective To study the clinical significance of thrombomdulin as a molecular marker indicating vascular endothelium injury.Methods Plasma concentration of thrombomodulin(TM) were measured in patients with acute leukemia(AL),diabetes mellitus(DM) and liver disease.Results The results showed that ①Plasma level of TM significantly increased in AL group and decreased after remission.However,no marked difference was detected between ANLL and ALL group.②Plasma level of TM was noteworthily elevated,with higher level in microangiopathy group than that in nonmicroangiopathy group.45% of the latter group appeared higher comparing the normal control.③Plasma level of TM also increased remarkably in liver disease patients,except in acute hepatitis group.The levels of acute fatal hepatitis and decompensated liver cirrhosis group were higher than those in acute hepatits and compensated liver cirrhosis group respectively.Conclusion Different degree of vascular endothelial cell injury exists in these patients,and measurement of plasma thrombomodulin is useful in predicting procession of the diseaese.