急性脑梗死患者蛋白C活性依赖凝固时间标准化比值降低

Decreased protein C activity-dependent clotting time normalized ratio in patients with acute cerebral infarction

目的观察急性脑梗死患者蛋白C活性依赖凝固时间标准化比值(PCAT-NR)与相关凝血指标纤维蛋白原(Fib)、凝血因子Ⅶ活性(FⅦ:C)、凝血因子Ⅷ活性(FⅧ:C)、抗凝血酶(AT)、D二聚体(DD)的相关性。方法经临床及影像学确诊急性脑梗死患者100例为病例组,选取75例体检健康者为健康人对照组,检测Fib、FⅦ:C、FⅧ:C、AT、PCAT-NR、DD并比较两组间差异;分析急性脑梗死患者PCAT-NR下降组与PCAT-NR正常组Fib、FⅦ:C、FⅧ:C、DD、AT结果差异;分析急性脑梗死患者PCAT-NR与其他凝血指标的相关性。结果急性脑梗死组Fib(3.38±1.25)g/L、FⅦ:C(130.5±15.9)%、FⅧ:C(135.8±43.1)%、DD(2.12±3.01)mg/L均高于健康人对照组,而AT(83.94±14.95)%、PCAT-NR(0.87±0.23)结果均低于健康人对照组,P均<0.05;急性脑梗死组患者PCAT-NR下降组Fib(4.03±1.25)g/L、FⅦ:C(138.2±6.9)%和FⅧ:C(151.5±54.9)%结果均高于正常组(P均<0.05),而DD、AT差异无统计学意义(P均>0.05);急性脑梗死患者PCAT-NR与Fib、FⅧ:C、DD呈负相关(r分别为-0.484、-0.356、-0.473,P均<0.05),与FⅦ:C、AT无相关性(P均>0.05)。结论急性脑梗死患者PCAT-NR水平下降与高凝状态有关,与Fib和凝血因子Ⅷ活性有一定关联。

Objective To observe the correlation between protein C activity-dependent clotting time-normalized ratio（ PCAT-NR） and the related blood coagulation parameters,e. g.,fibrinogen（ Fib）,factor Ⅶ coagulant activity（ Ⅶ： C）,factor Ⅷcoagulant activity（ FⅧ： C）,antithrombin（ AT）,D-dimer（ DD） in patients with acute cerebral infarction. Methods One hundred cases of patients who were diagnosed as acute cerebral infarction according to clinical manifestations and imaging examinations were taken as the test group and 75 healthy subjects were taken as control group. The values of Fib,FⅦ： C,FⅧ： C,AT,PCAT-NR,DD were tested and the difference between the two groups were compared. The differences of Fib,FⅦ： C,FⅧ： C,DD and AT between declined PCAT-NR group and normal PCAT-NR group in the patients with acute cerebral infarction were analyzed. The correlations of PCAT-NR with other coagulation parameters in acute cerebral infarction cases were compared. Results The values of Fib（ 3. 38 ± 1. 25） g/L,F Ⅶ： C（ 130. 5 ± 15. 9） %,FⅧ： C（ 135. 8 ± 43. 1） % and DD（ 2. 12 ± 3. 01） mg/L in the acute cerebral infarction group were significantly higher than those of control group,while the values of AT（ 83. 94 ± 14. 95） % and PCAT-NR（ 0. 87 ± 0. 23） in test group were significantly lower than those the control group（ P〈0. 05）. The values of Fib（ 4. 03 ± 1. 25） g/L,FⅦ： C（ 138. 2 ± 6. 9） % and FⅧ： C（ 151. 5 ± 54. 9） % of PCAT-NR declined group in the patients with acute cerebral infarction were significantly higher than those of PCAT-NR normal group（ P〈0. 05）,while the values of DD,AT were not statistically different between two groups（ P〈0. 05）. The values of PCAT-NR were significantly negatively correlated with Fib,FⅧ： C and DD in the patients with acute cerebral infarction（ r =-0. 484,-0. 356 and-0. 473,respectively（ all P〈0. 05）. There was no correlation of PCAT-NR with FⅦ： C and AT（ P〈0. 05）. Conclusion The PCAT-NR decline was associated with high coagulation state in patients with acute cerebral infarction. This decline has some correlation with high level of blood clotting factor Ⅷ and Fib.