系统性红斑狼疮患者血浆中生理性和病理性抗凝物的检测

Measurement of Plasma Anticoagulants in Patients with Systemic Lupus Erythematosus

目的探讨系统性红斑狼疮(SLE)患者血浆中生理性和病理性抗凝物水平,探讨抗凝血酶活性(AT:A)、蛋白C活性(PC:A)、蛋白S活性(PS:A)和狼疮样抗凝物质(LA)与血栓形成的关系。方法采用血浆蝰蛇毒时间法测定92例SLE患者(包括30例活动期与30例非活动期患者)及30名健康对照者(对照组)的LA比值(LAC),同时采用凝固法、发色底物法分别测定血浆蛋PC:A、PS:A及AT:A。结果 SLE患者PC:A、PS:A显著下降,LAC和正常对照组相比有显著增高。但两组之间的AT:A无显著差异。SLE患者活动期PC、PS活性明显下降,LAC和AT活性则无显著性差异(P>0.05)。结论 SLE患者易发血栓,尤其在活动期多发。狼疮抗凝物增多,PC、PS活性降低是导致血栓的重要因素。因此,PC∶A、PS∶A和LA联合检测可预测SLE并发血栓。

Objective To measure the level of plasma anticoagulants in patients with systemic lupus erythematosus（SLE） and to investigate the relation of antithrombin activity,protein c activity,protein s activity and lupus anticoagulants in patients with thrombosis.Methods 92 patients with SLE（including thirty cases of active stage and 30 cases of inactive patients） and 30 healthy subjects were enrolled in the study.AT：A,PC：A、PS：A and the ratio of LA（LAC） were measured by russell viper venom time（RVVT）,solidification method and colorimetric method,respectively.Results The results of PC：A,PS：A from SLE patients were significantly lower than that from control group and the results of LAC was higher than that from control group,while there was no significant difference in AT：A between two groups.The levels of PC：A and PS：A were lower in the active stages.There were no significant difference between LAC and AT in active cases and that in inactive patients.Conclusion Reduced PC∶A and PS：A and increased LA are the important factors that lead to thrombosis.Therefore,combined measurement of LA,PC：A and PS：A should forecast SLE patients with thrombus complication.