慢性尿毒症患者蛋白C、蛋白S、血栓烷B_2、P-选择素水平的观察

Variations of Protein C, Protein S, Thromboxane B_2 and P-seJectin in Chronic Uremic Patients

目的:探讨慢性尿毒症患者蛋白C系统和血小板活化状态的变化。方法:采用酶联免疫吸附双抗体夹心法测定30例慢性尿毒症患者血液透析前血浆蛋白C、蛋白S、血栓烷B_2、P-选择素含量,并对其中9例血液透析前后的相关指标进行了比较。结果:30倒尿毒症患者66.7％发现蛋白C水平低下,未发现蛋白S水平低下,平均蛋白C水平降低而蛋白S水平增高。血液透析后两者均较透析前显著增高。血液透析前TXB_2水平增高,P-选择素水平降低,血液透析后两者改变与透析前比较差异无显著性。结论:尿毒症高凝状态与蛋白C水平低下血小板活化异常有关。血液透析可纠正蛋白C异常,对血小板活化状态的改善不明显。

Objective: To explore the variations of protein C system and platelet activation in chronic uremic patients. Methods: The plasma levels of protein C, protein S, thromboxane B2 and P-selectin were detected by ELASA method in 30 chronic uremic patients before hemodialysis and 9 of them after hemodialysis. Results: The impaired protein C levels were found in 66. 7% of 30 uremic patients. The average protein C level increased while protein S level decreased before hemodialysis, which both increased significantly after. The TXB2 level were high while P-selectin level were low before hemodialysis, and the differences before and after hemodialysis were not significant. Conclusion: The defects of protein C system and abnormality of platelet activation may contribute to the hypercoagulability in uremia. Hemodialysis could lead to normalization of protein C, but it could not affect platelet activation significantly.