机械瓣膜替换术后抗凝血浆蛋白C含量改变的意义

The Significance of the change of plasma protein C in patients having oral anticoagulant after mechanical prosthetic valves operation.

目的探讨机械瓣膜替换术后口服华法令者 ,血浆蛋白 C,PC)的改变以及与其他凝血因子改变的关系。方法采用酶联免疫吸附法测定 PC含量 ,采用经典一期法测定凝血因子 X∶ C、凝血酶原时间并计算国际正常化比值 (INR)。结果正常对照组 (n=45 ) ,口服华法令组 (n=78) PC含量分别为 (5 .0 0± 0 .6 4) m g/ L、(2 .5 4± 2 .18)mg/ L ,两者差异有极显著性 (P<0 .0 0 1)。服药时间 1～ 6个月、7～ 2 4个月、2 5～ 132个月者 PC含量分别为 (4.0 2±3.6 0 ) mg/ L、(2 .5 2± 1.5 6 ) m g/ L、(2 .40± 1.6 6 ) m g/ L。 PC含量改变与因子 X、凝血酶原时间 (PT)、INR间无明显相关性。结论机械瓣膜替换术后口服华法令者血浆蛋白 C含量减低 ,并与服药时间长短有关 ,蛋白 C的改变存在较大的个体差异。在抗凝治疗初期 ,对蛋白 C含量的监测有着特别重要的意义。

Objective To investigate the changes of plasma protein C (PC) in patients having oral warfarin after mechanical prosthetic valves operation and its relationship with the changes of other coagulation factors. Methods Plasma PC was measured by ELISA.FX:C,and PT(INR) were measured by one stage method. Results The concentration of PC of control group and oral warfarin group were(5.0±0.64)mg/L,(2.54±2.18)mg/L respectively. There was significant difference between the two groups. These concentrations of PC were(4.02± 3.60)mg/L, (2.52±1.56)mg/L and (2.40±1.66)mg/L,in patients who have warfarin for 1～6 months, 7～24 months and 25～132 months respectively. The change of PC have no correlation with FX、PT and INR. Conclusion The patients having oral warfarin with mechanical prosthetic valves operation, had a lower concentration of PC, and it related with the time of having warfarin, there was great individual variation, in the change of plasma PC. Surveillance of PC may have important clinical significance in the early stage of anticoagulant treatment.