血浆蛋白C、蛋白S、抗凝血酶Ⅲ活性变化与急性肺血栓栓塞症相关性研究

Correlation of Activity Change of Plasma Protein C,Protein S and Antithrombin Ⅲ in Patients with Acute PTE

目的探讨血浆蛋白C(PC)、蛋白S(PS)、抗凝血酶Ⅲ(AT-Ⅲ)活性变化与肺血栓栓塞症(PTE)发生的关系。方法收集符合纳入标准的PTE患者60例(PTE组),同期存在PTE形成的危险因素的非PTE患者55例(高危组),健康人群60例(对照组),检测患者血浆PC、PS、AT-Ⅲ活性,用比较三组患者Caprini评分和抗凝因子PC、PS、AT-Ⅲ活性的差异。结果 Caprini评分三组间比较差异有统计学意义(P<0.05),PTE组与高危组比较差异无统计学意义(P>0.0167),PTE组和高危组的致PTE危险度高于对照组(P均<0.0167);PTE组、高危组抗凝因子PC、PS、AT-Ⅲ活性均较对照组下降(P均<0.0167);而PTE组与高危组两组间三种因子活性下降比较差异无统计学意义(P>0.0167)。结论临床检测血浆PC、PS、AT-Ⅲ活性降低其易栓风险较健康人群增高,但与PTE的发生可能无关。

Objective To explore association of activity change of plasma protein C（ PC）,protein S（ PS）,antithrombin Ⅲ（ AT- Ⅲ） in patients with Pulmonary Tromboembolism（ PTE）. Methods There were three groups in this study,60 PTE patients＇ group,55 high- risk- factor patients＇ group and 60 control subjects.Activities of PC and AT- Ⅲ were determined by chromogenic substrate method and PS by clotting method.Subjects in the three groups were divided into high risk level,middle risk level,low risk level and very low risk level according to Venous Thromboembolism（ VTE） risk factor by Caprini Score Risk Assessment Model.Results The activities of PC,PS and AT- Ⅲ in the PTE patients＇ group and high- risk- factor patients＇ group were significantly lower than those in control group（ P〈0. 01）,Whereas there were no significant differences in the three factors＇ activities between PTE patients＇ group and high- risk- factor patients＇ group（ P〉0. 05）. Caprini Scores of the two groups were both significantly higher than those in control group（ P〈0. 01）while there were no significant differences between PTE patients＇ group and high- risk- factor patients＇ group（ P〉0. 05）. Conclusion The findings show that alteration in activities of plasma PC,PS and AT- Ⅲ may not be associated with the occurance of PTE.