血浆凝血因子Ⅶ测定在缺血性心脑血管病与糖尿病中的临床意义

Detection of Plasma Coagulation Factor Ⅶ in Patients with Ischaemic Cardiocerebral Vascular Diseases Diabetes Mellitus and its Clinical Significance

目的:对缺血性心脑血管病(冠心病、脑血管病)及糖尿病患者血浆中FⅦa、FⅦ:Ag与FⅦ:C进行检测,并探讨其临床意义。方法:FⅦa测定采用重组可溶性组织因子法,FⅦ:Ag测定采用ELISA法,FⅦ:C采用一阶段凝固法。结果:冠心病中稳定型心绞痛组、不稳定型心绞痛组、急性心肌梗死组和糖尿病组FⅦa测定结果各为2.6±0.8(ny/ml)、2.8±0.9、2.9±0.9与2.8±1.0。均较正常对照组(2.2±0.7)为高,差异呈显著性(P<0.05)。4组中FⅦa/FⅦ:Ag各为3.20、3.88、3.81与3.73,均较正常对照组(2.61)为高,差异呈显著性(P<0.05)。4组中的FⅦ:C在稳定型心绞痛组与糖尿病组增高(P<0.05),不稳定型心绞痛组降低(P<0.05),急性心肌梗死组正常,而FⅦ:Ag仅稳定型心绞痛组降低(P<0、05),而其它3组无明显改变。缺血性脑血管病中短暂性脑缺血发作组FⅦa、FⅦ:C与FⅦa/FⅦ:Ag均增高,各为2.61±1.0 ng/ml、101±27％与3.33(P<0.05),FⅦ:Ag无明显改变。结论:以往认为FⅦ:C增高是缺血性心脑血管病发生的高危因子,本检测认为FⅦ:C增高并不恒定,而FⅦa增高和FⅦa/FⅦ:Ag比值增高较为恒定。从而认为:用检测FⅦ来评估缺血性心脑血管病及其危险事件的发生时,应包括FⅦa、FⅦ:Ag与FⅦ:C三项,并从中计算FⅦa/FⅦ:Ag比值,可能较单一指标为妥。

Objective: To detect plasma level of activated factor Ⅶ(FⅦa), factor Ⅶ antigen (F Ⅶ: Ag) and factor Ⅶ coagulant activity (F Ⅶ:C) in patients with ischaemic cardiocerebral vascular disease (coronary heart disease, cerebral vascular disease) diabetes mellitus and discuss its clinical significance. Methods: F Ⅶa was detected with recombinant factor method. F Ⅶ:Ag was detected with ELISA method. Phase I coagulation method was used to detect F Ⅶ:C. Results: F Ⅶ a levels were respectively 2.6±0.8 (ng/ml), 2.8±0.92.9±0.9, 2.8±1.0 in patients with stable angina (n=30), unstable angina, acute myocardial infarction and diabetes mellitus (n = 20), all of which were significantly (P<0.05) higher than those of controls (2.2±0.7). F Ⅶa/F Ⅶ:Ag values were separately 3.20, 3.88, 3.81 and 3 . 73 . All were significantly higher than those of controls (2.61) were. F Ⅶ coagulation activity rose up in patients with stable angina and diabetes mellitus (P<0.05), fell down its patients with unstable angina (P<0. 05) and remained normal in patients with AMI. Whereas F Ⅶ antigen level only decreased in patients with stable angina (P<0.05). Remained unchanged in the other 3 groups. F Ⅶ a, F Ⅶ: C and F Ⅶa/F Ⅶ: Ag were respectively 2. 6±1.0 ng/ml, 101±27% and 3.33 in patients with transient ischeamic attack(n = 20). Conclusion: Formerly, it is thought that increase of F Ⅶ:C was a risk factor of ischaemic cardiocerebral vascular disease. But, the results of this study showed that patients with ischaemic cardiocerebral vascular disease don't always have higher F Ⅶ: C levels, but usually have increased F Ⅶa, F Ⅶa/F Ⅶ:Ag levels. So we concluded that, it's necessary to detect F Ⅶa, F Ⅶ:Ag, F Ⅶ:C and want the F Ⅶa/F Ⅶ: Ag value when you evaluate the risk factors of ischaemic cardiocerebral vascular disease and its incidence, it is bet- ter than detection of single standard.