肝素治疗过敏性紫癜患儿血浆组织因子途径抑制物水平变化的意义

Significance of Changes of Plasma Levels of Tissue Factor Pathway Inhibitor in Children with Henoch-Schonlein Purpura Treated by Heparin

目的探讨过敏性紫癜(HSP)患儿血浆组织因子途径抑制物(TFPI)水平及肝素对血浆TFPI水平的影响。方法选择符合纳入标准的HSP患儿46例为HSP组,健康儿童23例为健康对照组。采用酶联免疫法检测2组血浆TFPI水平并进行比较;46例HSP患儿按入院奇偶顺序分为基础治疗组和肝素治疗组。2组均予基础治疗,肝素治疗组另加小剂量肝素应用。于治疗前、治疗后7d和14d,检测2组血浆TFPI水平,并应用SPSS12.0软件进行统计学分析。结果1.HSP组血浆TFPI水平为(59.337±21.750)μg/L,较健康对照组[(88.761±12.214)μg/L]显著降低(t=7.185P<0.01);2.基础治疗组治疗前、治疗后7d和14d,血浆TFPI水平分别为(59.639±24.568)μg/L、(62.726±17.507)μg/L和(71.209±23.055)μg/L;而肝素治疗组相应时间分别为(59.035±19.075)μg/L、(88.743±21.329)μg/L和(87.774±14.678)μg/L,2组比较有统计学意义(χ2=2.185P>0.05)。根据双因素重复测量变量的方差分析,在3个时间点上内部显示:F=25.020P<0.01,球形检验结果,F=12.098P<0.01。结论儿童HSP发作期血浆TFPI水平降低,随着时间延长呈上升趋势,肝素治疗参与了该趋势的形成,且维持一定时间。

Objective To investigate the plasma levels of tissue factor pathway inhibitor （TFPI） in children with Henoch - Schonlein purpura（HSP） and the changes of it after therapy with heparin. Methods Forty - six HSP children were enrolled in HSP group according to the criterion, and 23 normal healthy children as controls. The plasma levels of TFPI were measured by enzyme linked immuuosorbent assay in both groups. Forty - six HSP children were divided into 2 groups randomly ： heparin therapy group （ n = 23 ） and conventional therapy group （n = 23 ）. The plasma levels of TFPI were measured before therapy, on the 7^th day and the 14^th day after therapy, respectively. Results 1. The plasma levels of TFPI in HsP group [（59. 337 ± 21. 750） μg/L] significantly decreased than those of control group [ （88.761 ± 12. 214） μg/L] （t = 7. 185 P 〈 0.01 ）;2. The plasma levels of TFPI in conventional therapy group before therapy, on the 7th day and the 14^th day after therapy were （59. 639 ± 24. 568 ） μg/L, （ 62. 726 ± 17. 507 ） μg/L and （71. 209 ± 23. 055 ） μg/L, respectively, and those of heparin therapy group were（59. 035 ± 19. 075 ） μg/L, （88. 743 ± 21. 329） μg/L and （87. 774 ± 14. 678 ）μg/L, respectively. Through the two - factor analysis of variance,it showed that the plasma levels of TFPI tend to increase as time went by （ F = 25. 020 P 〈 0.01 ）, and heparin therapy increased them more significantly than conventional therapy （ F = 12. 098 P 〈 0.01 ）. Conclusions The plasma levels of TFPI in HSP children obviously decreased. As time went by, the plasma levels of TFPI tend to increase, and heparin therapy increased them more significantly than conventional therapy.