系统性红斑狼疮患者血浆部分抗凝物质与血栓形成关系的研究

The relationship between plasma anticoagulants and thrombosis in patients with systemic lupus erythematosus

目的 研究系统性红斑狼疮 (SLE)患者血浆蛋白C(PC)、蛋白S(PS)活性水平、活化蛋白C抵抗 (APCR)和狼疮样抗凝物质 (LA)阳性率 ,探讨SLE患者发生血栓的机制。方法 用凝固法在SysmexCA 15 0 0、CA 6 0 0 0全自动血凝仪上检测 4 4例SLE患者和 4 0例正常对照的血浆PC、PS活性、活化蛋白C反应性和LA。结果 SLE组血浆PC、PS活性分别为 (10 6 5± 14 3) %、(98 8± 19 6 ) % ,与对照组相比差异均无显著性意义 (均P >0 0 5 )。SLE组APCR阳性率为 36 4 % ,明显高于对照组 2 5 % (P <0 0 1) ,SLE组LA阳性率为 18 2 % ,明显高于对照组 0 % (P <0 0 5 )。相关性分析表明LA、APCR阳性均与SLE患者血栓形成有关 (均P <0 0 5 ) ,LA和APCR之间有相关性 (P <0 0 5 )。结论 SLE患者血栓形成与血浆PC、PS活性无关 ,与APCR、LA有关 ,且APCR与LA密切相关 ,APCR、LA是SLE患者血栓形成危险性增高的指标。

Objective To observe the levels of plasma protein C(PC),protein S(PS)and the occurrence of activated protein C resistance (APCR), lupus?like anticoagulants (LA) in patients with systemic lupus erythematosus(SLE),and investigate the occurring mechanism of thrombosis in SLE. Methods Clotting assay on Sysmex CA 1500 and CA 6000 autoanalyzer were used to detect the activity of plasma PC,PS and the occurrence of APCR,LA in 44 patients with SLE and 40 normal controls (NC).Results The activity of plasma PC,PS in SLE were (106 5±14 3)%,(98 8±19 6)%,respectively. There were no significant difference of PC,PS between SLE group and NC group (P>0 05) The positive rate of APCR in SLE(36 4%) was significantly higher than that in NC group (2 5%)(P<0 01),and the positive rate of LA in SLE (18 2%) was significantly higher than that in NC group (0%,P<0 05).LA and APCR were associated with thrombosis (P<0 05). There was close relationship between APCR and LA(P<0 05).Conclusion There is no relationship between the activity of plasma PC,PS and the thrombosis in patients with SLE. APCR is closed related to LA in SLE. APCR and LA seem to be the reasons for inducing the thrombosis in patients with SLE.