ADAMTS13在血栓前疾病状态中的水平及其相关因素分析

ADAMTS13 Level in Prothrombotic Status and Its Related Factor Analysis

目的:检测血栓前状态病例血浆中血管性血友病因子裂解蛋白酶(ADAMTS13)的活性水平并探讨其临床意义,同时分析ADAMTS13与血管性血友病因子(v WF)、凝血酶敏感蛋白1(TSP1)、C-反应蛋白(CRP)、肌酐等生化指标和血压等因素是否存在一定的相关性。方法:用残余胶原结合试验(R-CBA)检测病例组(急性早幼粒细胞白血病、恶性肿瘤、败血症等患者共260例)及50例正常对照组血浆中ADAMTS13的活性,ELISA试剂盒检测两组血浆中TSP1和v WF蛋白水平,同时对病例组血浆CRP、肌酐等生化指标和血压水平等与ADAMTS13活性关系进行相关性分析。结果:病例组血浆中ADAMTS13活性均显著低于正常对照组(P<0.05),TSP1及v WF蛋白水平均高于对照组(P<0.05);相关性分析发现,ADAMTS13活性与TSP1、肌酐、血糖、血压、D-二聚体及CRP呈负相关(r=-0.25至r=-0.54,P<0.05),与血脂、血型、血小板数目、血红蛋白无明显相关性(P>0.05)。结论:血栓前状态病例血浆中ADMATS13活性降低,提示ADAMTS13的减少与血栓前状态疾病的发病相关。检测血浆中ADAMTS13的活性有助于对血栓前疾病的诊断。

Objective:To detect the plasma activity of von Willebrand factor-cleaving protease(ADAMTS13) in the patients with prothrombotic status,and explore the effect and significance of ADAMTS13 in the prothrombotic status.The correlation of ADAMTS13 with von Willebrand factor(vWF),thrombospondin 1(TSP1),C-reactive protein etc,and blood pressure was simultaneously analyzed.Methods:The activity of ADAMTS13 in patient groups(atherosclerosis,diabetes,acute promyelocytic leukemia,cancer and sepsis,a total of 260 cases) and in control group50 cases were evaluated by residue collagen binding assay(R-CBA),the protein levels of TSP1 and vWF were measured by ELISA kits;the correlation of ADAMTS13 activity with CRP,creatinine,and blood pressure was analyzed with statistical soft ware.Results:The activity of plasma ADAMTS13 in patient group was significantly lower than that in normal control group(P <0.05).And the protein levels of TSP1 and vWF in the patients with prothrombotic status were higher than those in the normal controls(P < 0.05).Analysis of the correlation showed that the ADAMTS13 activity correlated negatively with the levels of TSP1 protein,blood sugar,blood pressure,D-dimer,creatinine,and CRP levels(P<0.05),however,the ADAMTS13 activity did not significantly correlate with the levels of serum lipids,blood type,platelet number and hemoglobin level(P >0.05).Conclusion:The plasma ADAMTS13 activity is decreased in the patients with prothrombotic status,suggesting that the decreased ADAMTS13 activity may participate in the occurrence of prothrombotic status,and the dectection of plasma ADAMTS13 activity may help the diagnosis of prothrombotic disease.