无诱因肺血栓栓塞症患者天然抗凝蛋白活性缺陷发生率的研究

Analysis on prevalence of deficiency on natural anticoagulant in patients with unprovoked pulmonary thromboembolism

目的:探讨汉族无诱因肺血栓栓塞症(uPTE)患者和健康人群中蛋白C(PC)、蛋白S(PS)和抗凝血酶Ⅲ(ATⅢ)三种天然抗凝蛋白(NA)活性缺陷的发生率。方法:自2010年1月至2017年12月,连续分析我院呼吸与危重症医学科住院的汉族uPTE患者265例和汉族健康对照人群68例,检测PC,PS和ATⅢ三种NA的活性水平并计算活性缺陷的发生率。结果:265例汉族uPTE患者三种NA缺陷的发生率为34.3%(91/265),PC和PS联合缺陷31例(11.7%)、单纯PC缺陷28例(10.6%)和单纯PC缺陷22例(8.3%)居于发生率的前三位,性别间差异无统计学意义(P=0.78),总发生率显著高于健康对照组2例(2.9%,P<0.01)。结论:我国汉族uPTE患者中NA缺陷发生率高,性别间无差异,显著高于健康人群,对PTE的发生有重要影响。

Objective： To analysis the prevalence of deficiency on natural anticoagulant（ NA） including protein C（ PC）,protein S（ PS） and antithrombin Ⅲ（ ATⅢ） in Han Chinese patients with unprovoked pulmonary thromboembolism（ uPTE）. Methods： Consecutive 265 Han Chinese uPTE patients（ 140 male,125 female） in department of pulmonary and critical care medicine in Beijing Anzhen Hospital from January 2010 to December 2017 and 68 healthy controls were enrolled. Levels of PC,PS and ATⅢ and incidence of these deficiencies were analyzed. Results： Prevalence of NA deficiency including PC,PS and ATⅢ in Han Chinese uPTE patients is 34. 3%（ 91/265）. 31 patients（ 11. 7%） suffered from combined PC and PS deficiency,28（ 10. 6%） with PS and 22（ 8. 3%） with PC deficiency respectively,which were most 3 common deficiency pattern. No difference of incidence with NA deficiencies was observed between genders（ P = 0. 78）. Compared to health controls（ 2. 9%）,the incidence with NA deficiencies was significantly higher in uPTE patients（ P〈0. 01）. Conclusion： It indicated that the prevalence of NA deficiency was high in Han Chinese uPTE patients compared to health controls and no difference was observed between genders. NA deficiency may be correlated with the pathogenesis of PTE.