抗凝血酶、蛋白C、蛋白S性别和年龄特定正常参考范围研究

Normal reference ranges of antithrombin,protein C and protein S:effect of sex and age

目的探讨性别、年龄对健康个体天然抗凝蛋白血浆水平的影响,并评估是否需要单独的参考范围。方法回顾分析2022年1月至2022年5月一龄生命养护中心进行体检的健康人群抗凝血酶(AT)、蛋白C(PC)和蛋白S(PS)活性,对比不同年龄抗凝蛋白的动态变化以及不同性别抗凝蛋白的差异,探讨天然抗凝蛋白的参考范围。两组数据对比使用非参数检验Mann⁃Whitney方法,参考范围按照实验室标准委员会C28⁃A3C的要求进行计算。结果研究人群包括5206名健康成年人(2194名男性,3012名女性),年龄18~92岁,中位年龄为52岁。男性和女性之间的PC和PS活性差异有统计学意义。AT在男女之间无统计学意义。男性PC在18~35岁逐渐上升,35~85岁逐渐下降;女性PC在19~70岁逐渐上升,70~92岁逐渐下降;男性PS在18~85岁随年龄增长逐渐下降,女性PS在19~92岁则相对稳定,男性PS整体水平高于女性;男性AT随年龄逐渐下降,女性各年龄段相对稳定。结论对于AT、PC和PS来说,性别和年龄特定的正常参考范围是有必要的,可以更好地鉴别天然抗凝蛋白缺乏的携带者,给临床诊断和治疗提供更为精准的依据。

Objective The aim of this study was to investigate the effect of sex and age on natural anticoagulant plasma levels in a large group of healthy individuals and to evaluate the need of separate reference ranges.Methods A prospective study was designed,the healthy people who undergo physical examinations at the Boao Yiling Life care Center.Antithrombin(AT),protein C(PC)and protein S(PS)activities was detected to compare the dynamics of anticoagulant proteins at different ages and the different reference range in anticoagulant proteins by gender.The two data sets were compared using the non⁃parametric test Mann⁃Whitney method,and the reference ranges were calculated according to the Laboratory Standards Committee C28⁃A3C.Results The research population included 5206 healthy people(including 2194 men and 3012 women)ranging in age from 18 to 92 years(median age:52 years).There is a statistically significant difference in PC and PS activity between males and females.There was no statistically significant difference in AT between men and women.Male PC gradually rises from 18 to 35 years old,and gradually decreases from 35 to 85 years old;female PC gradually rises from 19 to 70 years old,and gradually decreases from 70 to 92 years old.PS and AT were progressively declined with age in men and was relatively stable in women,but men have higher PC level than women.Conclusion For AT,PC and PS,sex⁃and age⁃specific normal reference ranges are necessary to better identify carriers of natural anticoagulant protein deficiency and to give more precise data for clinical diagnosis and treatment.