系统性红斑狼疮患者蛋白C系统及抗凝血酶Ⅲ变化的研究

Study on Changes in Protein C System and Antithrombin Ⅲ in Patients with Systemic Lupus Erythematosus

目的 观察系统性红斑狼疮 (SLE)患者血浆蛋白C系统和抗凝血酶Ⅲ水平的变化 ,以及活化蛋白C抵抗 (APCR)的发生率 ,探讨SLE患者发生血栓的机制。方法 凝固法在全自动血凝仪上检测 3 0例SLE患者和 3 0例正常对照的血浆PC、PS活性 ,发色底物法测定活化蛋白C(APC)和抗凝血酶Ⅲ (ATⅢ )活性。结果 与正常对照组相比 ,SLE患者的PC、PS下降 ,分别为( 4 7.0± 2 4.0 ) % ,( 3 6.0± 15 .5 ) % ;差异有显著性意义 (P <0 .0 5 )。SLE组APCR阳性率为 3 6.7% ,明显高于正常对照组 6.7% (P<0 .0 1)。抗凝血酶Ⅲ (ATⅢ )活性在两组间无显著性差异 (P >0 .0 5 )。结论 SLE患者存在凝血的激活和抗凝系统的异常 ,蛋白C系统在SLE患者的血栓形成中起着重要作用。

Objectives To observe the levels of plasma protein C (PC), protein S (PS), antithrombin Ⅲ and the occurrence of activated protein C resistance ( APCR) in patients with systemic lupus erythematosus (SLE), and investigate the mechanism of thrombosis in SLE. Methods Clotting assay on autoanalyzer were used to detect the activity of plasma PC and PS , and the activities of activated protein C (APC) and antithrombin Ⅲ (ATⅢ) were measured by the chromogenic method in 30 patients with SLE and 30 normal controls(NC). Results The activity of plasma PC and PS in SLE were (47.0±24.0)% and (36.0±15.5)% respectively. There were significant difference of PC and PS between SLE group and control group(P<0.05). The positive rate of APCR in SLE (36.7%) was significantly higher than that in control (6.7%)(P<0.01). There were no significant difference of the activity of ATⅢ between SLE group and NC group(P>0.05). Conclusion There are activation of coagulation and abnormality of anticoagulant system in patients with SLE, and protein C system plays a major role in pathogenesis of the thrombosis in patients with SLE.