血栓疾病患者血浆肝素辅因子Ⅱ活性和抗原水平检测及意义

Heparin cofactor Ⅱ(HCⅡ) activity and antigen assay and their significance in thrombotic diseases

目的 了解肝素辅因子Ⅱ (HCⅡ )活性及抗原水平在动、静脉血栓性疾病中的变化及其与动、静脉血栓性疾病之间的关系。方法 用发色底物法测定 5 0名正常人 ,75例脑梗死、5 0例心肌梗死及 36例深静脉血栓患者血浆HCⅡ活性 ;发色底物法检测深静脉血栓患者中HCⅡ缺乏者血浆抗凝血酶 (AT)活性 ;Westernblot检测部分样品 (每组 36例 )血浆HCⅡ抗原含量。结果 血浆HCⅡ活性与其抗原呈平行变化 ;正常对照组血浆HCⅡ活性及抗原水平分别为 (96 .80± 2 0 .11) % ,0 .93± 0 .19与脑梗死组 [(99.97± 2 1.14 ) % ,0 .96± 0 .2 4 ]、心肌梗死组 [(98.18± 2 9.35 ) % ,0 .95± 0 .2 0 ]及深静脉血栓形成组 [(89.5 7± 17.12 ) % ,0 .87± 0 .18]比较 ,差异无显著性 ,但深静脉血栓形成组HCⅡ活性和抗原均呈降低趋势 ;HCⅡ明显减低者在正常人及患者之间的分布频度无显著差异 ;深静脉血栓中HCⅡ缺乏者血浆抗凝血酶活性及纤维蛋白原浓度正常。结论 血浆HCⅡ变化可能不是中国湖南汉族人心、脑血栓病的危险因子 ;是否与静脉血栓形成相关有待进一步证实。

Objective To study the plasma HCⅡ activity and antigen level variations and their relationship with arterial and deep venous thrombotic diseases. Methods Seventy-five patients with brain infarction (BI), 50 myocardial infarction (MI), 36 deep venous thromboembolic disease(DVT) and 50 healthy controls were entered in this study. Plasma HCⅡ activity was measured with chromogenic substrate method and the HCⅡ antigen level by Western blotting assay. Plasma antithrombin (AT) activity was detected for the HCⅡ deficiency individuals with DVT using chromogenic substrate method. Results There was no significant difference in the mean plasma HCⅡ activity and antigen levels between BI group [(99.97±21.14)% and 0.96±0.24], MI group [(98.18±29 35)% and 0.95±0.20] and healthy controls [(96.80±20.11)% and 0.93±0.19]. The plasma HCⅡ activity and antigen concentrations in patients with DVT [(89.57±17.12)% and 0.87±10.18] tended to be decreased as compared with healthy controls, but they were not significant. No significant difference was found for the prevalence of HCⅡ deficiency between patient groups and control group.The HCⅡ deficiency individuals with DVT had normal AT activity and fibrinogen concentration. Conclusions Plasma HCⅡ deficiency may not be the risk factor for arterial thrombosis in the Han population of Hunan Chinese. It is needed to further confirm if decreased plasma HCⅡ is correlated with venous thrombosis.