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C1酯酶抑制剂在危重病中的应用研究进展 被引量:1

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摘要 C1酯酶抑制剂(C1 INH)是血浆中的一种丝氨酸蛋白酶抑制剂,是目前已知的惟一能与丝氨酸蛋白酶C1s和C1r作用的抑制剂,也是激肽释放酶、活化的凝血因子FXⅡ(FXⅡa)、活化的凝血因子FXⅠ (FXⅠ a)的抑制剂.C1 INH是血浆中高度糖基化的单链糖蛋白,由478个氨基酸残基组成,蛋白质含量为51%,分子量约为104 kDa,共含有20个糖基化位点,位于ASN-330位点的糖基化结构对丝氨酸蛋白酶抑制区折叠效应的形成起重要作用[1].目前,一般将C1 INH分为丝氨酸蛋白酶抑制区和非蛋白酶抑制区两个区域.在分子结构上,蛋白酶抑制区具有9个α螺旋和3个β折叠[2].C1 INH主要在肝脏中合成,其他一些细胞(如单核细胞、巨噬细胞、血小板等)也具有合成能力.在补体系统中,C1 INH主要调节补体的经典活化途径,还可以与C3反应抑制C3b与B因子的结合,从而调节补体的旁路途径.在缓激肽释放系统中,C1 INH是FXⅡa的主要灭活剂,也抑制血浆中激肽释放酶的活性,还抑制前激肽释放酶对HK辅因子的裂解,从而抑制激肽的形成和释放,间接调节缓激肽的水平[3].在遗传性血管性水肿患者的急性发作期,激肽释放酶和FXⅡa直接活化纤维蛋白溶酶原,增强纤溶系统的活化,因此C1 INH对于纤溶系统的活化也具有调节作用.C1 INH还可以灭活47%的FXⅠ a[4],因此可以调节机体的内源性凝血系统.
出处 《山东医药》 CAS 2013年第36期99-101,共3页 Shandong Medical Journal
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二级参考文献7

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