全血细胞组织因子活性改变在血栓前状态中的意义

Significance of Measuring Whole Blood Tissue Factor in Prothrombotic State

目的检测血循环中血细胞组织因子促凝活性(tissue factor procoagulant activity,TF-PCA),观察有疑似弥散性血管内凝血(disseminated intravascular coagulation,DIC)、疑似深部静脉血栓形成(deep vein thrombosis,DVT)以及糖尿病(diabetes mellitus,DM)时,TF-PCA的改变及其在判断血栓前状态中的意义。方法受检病例95例(其中疑似DIC组12例,疑似DVT组36例,DM组47例)为我院近期住院和门诊患者,正常对照组38例为体检正常自愿献血者。采用脂多糖(lipopolysaccharide,LPS)刺激的全血复钙时间检测全血细胞TF活性(tissue factor clotting time,TiFaCT),根据全血凝固时间缩短的程度(△s)来判断TF-PCA的强弱,对其检测结果进行统计学分析。结果疑似DIC组、疑似DVT组及DM患者组TF-PCA分别是(85.8±16.9)△s、(69.8±17.5)△s、(67.1±21.4)△s,与正常组(30.4±25.1)△s比较差异有极显著性(P<0.01)。结论疑似DIC患者、疑似DVT患者和DM患者在LPS刺激后TF-PCA明显增强,TiFaCT对于血栓前状态的诊断及预后评价有重要临床参考价值。

Objective To observe the changes of TF- PCA in patients suspected with DIC or DVT and diabetic, and evaluate the significance of TF-PCA to the diagnosis of the prombotic state. Methods 95 samples were taken from hospitalized patients and out-patients（ 12 cases of suspected with DIC, 36 cases of suspected with DVT, and 47 cases of diabetes mellitus） , with 38 samples taken from examined people set as normal control. Recalcification time of LPS-stimulated whole blood was applied to evaluate tissue factor clotting time （TiFaCT）. TF-PCA were evaluated based on the decreased degree of whole blood recaleification time （△s）. And the results were analyzed by using the SPSS software pacakage. Results A retrospective and contrast anlysis indicated that As in patients suspected with DIC, patients suspected with DVT and diabetic were （85.8 ± 16.9）△s, （69.8± 17.5） △s and （67.1 ±21.4 ） △s, respectively. When compare with normal controls （30.4 ± 25.1 ） △s, the difference both had extremely statistical significance （P 〈 0.01 ）. Conclusion The levels of TF- PCA were obviously elevated after stimulated by LPS in patients suspected with DIC or DVT and diabetic. TiFaCT has an important clinical reference value for the diagnostic and prognostic evaluation of prombotic state.