Change of Coagulation Factor Ⅷ and Antithrombin Ⅲ Activity in Bank-Stored Blood

Coagulation factor Ⅷ and antithrombin Ⅲ activity were detected in 15 health donors. It was found that antithrombin Ⅲ activity decreased obviously 12 h after blood drawing. It lost 56 % of the activity at the 3rd day, and 70 % of the activity at the 7th day. FⅧ:c showed no obvious change after 24 h, until the 3rd day. It lost 40 %-60 % of the activity after 36 h and was reduced to the 30 % of the original activity at the 5th day. Our results suggested that at the 3rd day coagulation factor Ⅷ of bank stored blood can be used to replenish antithrombin Ⅲ, while bank stored blood in one day can be used to replenish FⅧ.

Insights into ionic association boosting water oxidation activity and dynamic stability

There have been reports about Fe ions boosting oxygen evolution reaction(OER)activity of Ni-based catalysts in alkaline conditions,while the origin and reason for the enhancement remains elusive.Herein,we attempt to identify the activity improvement and discover that Ni sites act as a host to attract Fe(Ⅲ)to form Fe(Ni)(Ⅲ)binary centres,which serve as the dynamic sites to promote OER activity and stability by cyclical formation of intermediates(Fe(Ⅲ)→Fe(Ni)(Ⅲ)→Fe(Ni)-OH→Fe(Ni)-O→Fe(Ni)OOH→Fe(Ⅲ))at the electrode/electrolyte interface to emit O_(2).Additionally,some ions(Co(Ⅱ),Ni(Ⅱ),and Cr(Ⅲ))can also be the active sites to catalyze the OER process on a variety of electrodes.The Fe(Ⅲ)-catalyzed overall water-splitting electrolyzer comprising bare Ni foam as the anode and Pt/Ni-Mo as the cathode demonstrates robust stability for 1600 h at 1000 mA cm^(-2)@~1.75 V.The results provide insights into the ioncatalyzed effects boosting OER performance.

Studies on Extraction and Activity of Peptides from Haemadipsa hainana

[Objectives]Peptides was extracted from Haemadipsa hainana and its activity was studied.[Methods]Electric stimulation,water extraction and ultrasonic extraction were used to extract the peptides from H.hainana.Then the protein content and molecular weight distribution of H.hainana peptides were detected by the BCA method and SDS-PAGE method,respectively.The antithrombin activity and analgesic activity of the three peptide extracts of H.hainana were detected by Markwardt thrombin titration method and mouse hot plate experiment,respectively.[Results]There extraction methods of electric stimulation,water extraction and ultrasonic extraction were used to extract the peptide extract of H.hainana,and the yields were as follows:water extraction>electrical stimulation>ultrasonic extraction.The three peptide extracts from H.hainana had antithrombin activity,and the antithrombin activity was as follows:water extraction>ultrasonic extraction>electrical stimulation.Through the hot plate experiment in mice,it was verified that the three peptide extracts of H.hainana had analgesic activity,and the analgesic activity was water extraction>electric stimulation>ultrasonic extraction.The analgesic activity of high-dose(100 mg/kg)group of H.hainana obtained by water extraction was slightly weaker than that of tramadol.[Conclusions]This study confirmed that the peptide extract of H.hainana had certain antithrombin and analgesic activity,laying a foundation for the subsequent development and application of H.hainana.

Synthesis, Characterization and Antibacterial Activity of New Ln(Ⅲ) Complex with Unsymmetrical Schiff Base Ligand

A new unsymmetrical Schiff base ligand (H_2LLi) was synthesized using L-lysine, o-vanillin and salicylaladyde. Three solid metal complexes of this ligand [Ln(H_2L)(NO_3)] NO_3·2H_2O (Ln=Sm, Ho, Tm) were prepared and characterized by elemental analyses, IR spectra, UV spectra, TG-DTG and molar conductance. The ligand synthesized are chelating agent. The nitrogen atoms of Schiff base, oxygen atoms of hydroxybenzene, methoxide and carboxyl are all coordinated to the metal ions. Carboxyl and the nitrate ion within the coordination sphere are coordinated to the metal ion in a mondentate or bidentate fashion. Water molecules are lied in crystal substances. The antibacterial activity of the ligand and its complexes was also studied. The antibacterial experiments indicate that they have antibacterial activity to E. coli, S. aureus, B. subtilis and the complexes have higher activity than the ligand.

抗凝血酶Ⅲ、脂蛋白相关磷脂酶A2与进展性脑梗死的关系

目的探讨血浆抗凝血酶Ⅲ(AT-Ⅲ)活性、血清脂蛋白相关磷脂酶A2(Lp-PLA2)水平与进展性脑梗死的关系。方法选取2018年1月至2019年6月金华市中心医院收治的95例脑梗死患者为研究对象,其中进展性脑梗死47例为观察组,非进展性脑梗死48例为对照组;选取同期本院健康体检的45名志愿者为健康组。比较3组研究对象治疗前以及观察组治疗前后血浆AT-Ⅲ活性、血清Lp-PLA2水平及美国国立卫生研究院卒中量表(NIHSS)评分,采用Pearson相关分析观察组治疗前血浆AT-Ⅲ活性、血清Lp-PLA2水平与NIHSS评分的相关性。结果观察组治疗前血浆AT-Ⅲ活性均明显低于对照组和健康组(均P<0.05),血清Lp-PLA2水平均明显高于对照组和健康组(均P<0.05);而对照组血浆AT-Ⅲ活性明显低于健康组(P<0.05),血清Lp-PLA2水平明显高于健康组(P<0.05)。观察组治疗第3、5、7天血浆AT-Ⅲ活性较治疗前明显降低(均P<0.05),而血清Lp-PLA2水平及NIHSS评分较治疗前均明显升高(均P<0.05);与治疗第5天比较,治疗第7天血浆AT-Ⅲ活性明显升高(P<0.05),而血清Lp-PLA2水平及NIHSS评分均明显降低(均P<0.05)。观察组治疗前血浆AT-Ⅲ活性与NIHSS评分呈负相关(r=-0.524,P<0.001),血清Lp-PLA2水平与NIHSS评分呈正相关(r=0.487,P<0.001)。结论血浆AT-Ⅲ活性、血清Lp-PLA2水平与进展性脑梗死患者病情发展及神经功能损害密切相关。

THE EFFECTS OF BREVISCAPIN ON AT－Ⅲ ACTIVITY， tPA AND PAI IN DOGS DURING ACUTE MYOCARDIAL ISCHEMIA

ＴＨＥＥＦＦＥＣＴＳＯＦＢＲＥＶＩＳＣＡＰＩＮＯＮＡＴ－ⅢＡＣＴＩＶＩＴＹ，ｔＰＡＡＮＤＰＡＩＩＮＤＯＧＳＤＵＲＩＮＧＡＣＵＴＥＭＹＯＣＡＲＤＩＡＬＩＳＣＨＥＭＩＡＳｈｅｎｇＪｉｎｇ（盛净），ＸｕＪｉｍｉｎ（徐济民），ＹａｎｇＪｕｘｉａｎ（杨菊贤），...

Synthesis,Characterization,Optical Property and Bioactivity of the Eu(Ⅲ)Complex with Aromatic Carboxylic Triazole

A novel complex{[Eu（H;TIA）(C;O;);（H;O）;]·H;O};of Eu（Ⅲ）with aromatic carboxylic triazole(H;TIA=5-（4H-1,2,4-triazol-4-yl）isophthalic acid,H;C;O;=oxalic acid)was hydrothermally synthesized and characterized by IR,UV-Vis,emission spectra and optical activity,and its crystal structure was determined.It crystallizes in triclinic system,space group P1 with a=7.4452（13）,b=10.776（2）,c=11.286（2）?,α=110.546（3）°,β=106.604（3）°,γ=99.031（3）°,V=486.0,GOOF=1.096,the final R=0.0196 and w R=0.0527 for 3081 observed reflections with I≥2σ（I）,R=0.0209 and wR=0.0535 for all data with（Δ/σ）;=0.001,（Δρ）;=0.48 and（Δρ）;=–0.46 e·?;.The natural bond orbital（NBO）charges,electrostatic potential（ESP）and frontier orbital of this complex were also analyzed.The results of anti-bacterial activity against Gram positive（S. aureus）and Gram negative（E. coli）bacteria reveal that the studied complex possesses a moderate inhibiting effect,and the inhibition effect on E.coli is better.

抗凝血酶Ⅲ、纤维蛋白原联合Geneva评分对肺癌患者并发肺血栓栓塞症的诊断价值

目的:探讨抗凝血酶Ⅲ(ATⅢ)、纤维蛋白原(FIB)联合Geneva评分对肺癌患者并发肺血栓栓塞症(PTE)的诊断价值。方法:选取2021年4月—2023年3月中国人民解放军陆军第七十三集团军医院收治的50例肺癌并发PTE患者纳入PTE组,选取同期肺癌未并发PTE的50例患者纳入对照组。收集并比较两组一般资料及血清ATⅢ、FIB水平、Geneva评分,采用logistic回归分析肺癌患者并发PTE的影响因素,应用受试者工作特征(ROC)曲线验证ATⅢ、FIB及Geneva评分对肺癌并发PTE的诊断价值。结果:PTE组冠心病、腺癌、TNM分期Ⅲ期、Ⅳ期、手术、化疗患者占比、D-二聚体、血红蛋白、ATⅢ、FIB及Geneva评分高于对照组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,ATⅢ、FIB、Geneva评分是肺癌并发PTE的独立影响因素(P<0.05)。ATⅢ、FIB、Geneva评分联合诊断的曲线下面积(AUC)为0.929,高于ATⅢ、FIB、Geneva评分单独诊断的0.776、0.783、0.771。结论:ATⅢ、FIB、Geneva评分均能很好地预测肺癌并发PTE,三者联合时诊断价值更高。

Fe(Ⅲ)/2,6-吡啶二羧酸活化高碘酸盐强化染料脱色的效能与机制

有色染料是环境中非常重要的污染源之一,严重威胁着水生生态环境和人类健康。由于其难以被天然降解,且传统的污水处理工艺亦无法实现其高效去除,因此急需开发绿色、高效的水处理工艺进行有色染料污染控制。发现Fe(Ⅲ)/2,6-吡啶二羧酸(2,6-PDA)可高效活化高碘酸盐(PI)实现亚甲基蓝(MB)这一典型染料的高效降解。实验结果表明,该体系在Fe(Ⅲ)浓度为10μmol/L、2,6-PDA浓度为10μmol/L和PI浓度为200μmol/L时,可在pH 3.0条件下使5 mg/L MB降解率在120 s内大于97%。该方法依托高级氧化原理和配位强化策略,利用PI对有色染料进行降解,为目前染料废水治理提供了新思路从而有效地修复了污染水体。

D-二聚体、抗凝血酶Ⅲ、纤维蛋白原及降解产物预测妊娠期高血压疾病的作用研究

目的:探究D-二聚体、抗凝血酶Ⅲ、纤维蛋白原及其降解产物检测对妊娠期高血压疾病(Hypertensive disorder complicating pregnancy,HDCP)患者的应用价值。方法:选取2021年1月至2023年5月于本院收治的76例妊娠期高血压疾病患者纳入HDCP组,选取同期70例健康孕妇人群作为对照组。检测对比两组的血浆D-二聚体(D-dimer,D-D)、抗凝血酶Ⅲ(Antithrombin III,AT-Ⅲ)、纤维蛋白原(Fibrinogen,FIB)及其降解产物(Fibrinogen degradation products,FDP)水平;探究D-D、AT-Ⅲ、FIB及FDP的水平对预测妊娠期高血压疾病的价值。结果:HDCP组的D-D、FIB及FDP水平均显著高于对照组,AT-Ⅲ水平显著低于对照组(P<0.05)。多因素Logistic回归结果显示,D-D、FIB、FDP水平越高,AT-Ⅲ水平越低的孕妇,发生妊娠期高血压的风险越大。受试者工作特征曲线(Receiver operating characteristic curve,ROC)分析结果显示,D-D、AT-Ⅲ、FIB及FDP水平预测妊娠期高血压疾病的曲线下面积(Area under curve,AUC)分别为:0.715、0.806、0.758、0.827,灵敏度分别为:47.4%、76.3%、85.5%、81.6%,特异度分别为:81.7%、80.4%、65.7%、85.7%。D-D、AT-Ⅲ、FIB及FDP水平联合预测的AUC为0.910,灵敏度为86.8%,特异度为90.0%。结论:孕妇的血浆D-D、AT-Ⅲ、FIB及FDP水平与妊娠期高血压疾病的发生相关联。D-D、FIB、FDP水平越高,AT-Ⅲ水平越低的孕妇,发生妊娠期高血压疾病的风险越大。D-D、AT-Ⅲ、FIB及FDP的水平对妊娠期高血压疾病患者有一定的预测价值。

Hcy、ATⅢ和ACA与下肢深静脉血栓形成后综合征患者临床预后相关性及对其预测价值

目的探讨同型半胱氨酸(Hcy)、抗凝血酶Ⅲ(ATⅢ)和抗心磷脂抗体(ACA)与下肢深静脉血栓形成后综合征(PTS)患者临床预后的相关性及对其预测价值。方法选取2016年1月—2018年1月收治的下肢深静脉PTS 120例作为观察组,下肢深静脉血栓形成60例作为对照组。比较观察组治疗前和对照组及不同预后下肢深静脉PTS患者治疗前后Hcy、ATⅢ、ACA,分析Hcy、ATⅢ、ACA对下肢深静脉PTS发生风险的影响,探讨Hcy、ATⅢ和ACA与下肢深静脉PTS患者临床预后相关性,分析Hcy、ATⅢ和ACA对下肢深静脉PTS患者临床预后预测价值。结果观察组治疗前Hcy和ACA高于对照组,ATⅢ低于对照组(P<0.01)。Hcy、ATⅢ和ACA高水平下肢深静脉PTS发生风险是低水平的4.652、0.414和3.588倍。治疗后,预后不良下肢深静脉PTS患者Hcy和ACA高于预后良好下肢深静脉PTS患者,ATⅢ低于预后良好下肢深静脉PTS患者(P<0.01)。Hcy、ATⅢ和ACA治疗前后差值绝对值预后不良下肢深静脉PTS患者低于预后良好下肢深静脉PTS患者(P<0.01)。Hcy、ATⅢ和ACA治疗前后差值绝对值与下肢深静脉PTS患者预后不良独立相关(P<0.01)。Hcy、ATⅢ和ACA三者联合对下肢深静脉PTS患者临床预后预测价值的受试者工作特征曲线下面积高于单一检测(P<0.05,P<0.01)。结论下肢深静脉PTS患者Hcy和ACA升高,ATⅢ降低。Hcy、ATⅢ、ACA与下肢深静脉PTS发病和临床预后相关,三者联合对下肢深静脉PTS患者临床预后的预测价值较高。

Effect of Lanthanum (Ⅲ) on Reactive Oxygen Metabolism of Soybean Seedlings under Supplemental UV-B Irradiation

The effect of lanthanum （Ⅲ） on reactive oxygen metabolism of soybean seedlings under elevated ultraviolet-B radiation（UV-B：280~320 nm）at 0.15 and 0.45 W·cm-2 levels respectively was studied through hydroponics in the laboratory.Plasmolemma permeability and contents of malonadialdehyde（MDA）,hydrogen peroxide（H2O2）,and proline gradually increased during the imposition of UV-B radiation and subsequently decreased during recovery from UV-B stress.The dynamic tendency of catalase（CAT）activity was similar to that of the above four indices.The activity of peroxidase（POD）initially increased,then remained at a high level,and finally dropped steeply when soybean seedlings were exposed to a low dosage of UV-B radiation.However,POD activity rose throughout and declined slightly on the eleventh day when soybean seedlings were stressed by a high dosage.With the addition of La （Ⅲ） of 20 mg·L-1,the rising tendency of plasmolemma permeability and contents of MDA,H2O2,and proline were slowed down during the stress period,whereas the declining speed was accelerated during the recovery period.The activities of CAT and POD were higher than those without La （Ⅲ） in all experiments.It suggested that the regulative effect of La （Ⅲ） on antioxidant enzymes such as CAT and POD could strengthen their capacities to scavenge reactive oxygen species（ROS）,decrease contents of MDA and proline,and maintain normal plasmolemma permeability.Further more,the protective potential of La （Ⅲ） was better under low UV-B radiation than under a high one.

复发性流产血栓前状态孕妇血清BNP、ATⅢ、Anti-β2-GPI水平对疾病转归的预测价值

目的 探讨复发性流产血栓前状态(PTS-RSA)孕妇血清脑钠肽(BNP)、抗凝血酶-Ⅲ(ATⅢ)、抗β2-糖蛋白Ⅰ抗体(Anti-β2-GPI)水平对疾病转归的预测价值。方法 选取PTS-RSA孕妇136例为观察组,选取同期RSA但不伴PTS孕妇68例为对照1组,正常孕妇68例为对照2组。检测三组血清BNP、ATⅢ、Anti-β2-GPI水平,对比观察组治疗前后血清BNP、ATⅢ、Anti-β2-GPI水平,采用logistic回归模型分析PTS-RSA孕妇保胎失败的影响因素,采用受试者操作特征(ROC)曲线及曲线下面积(AUC)分析BNP、ATⅢ、Anti-β2-GPI预测保胎失败的价值。结果 观察组治疗前血清BNP、Anti-β2-GPI高于对照1组、对照2组,对照1组高于对照2组(P<0.05);观察组治疗前血清ATⅢ水平低于对照1组,对照1组低于对照2组(P<0.05);观察组治疗后血清BNP、Anti-β2-GPI低于治疗前,ATⅢ水平高于治疗前(P<0.05);调整年龄、流产次数、饮酒史、月经情况、孕前调理后,治疗前后BNP、ATⅢ、Anti-β2-GPI水平仍与保胎失败有关(P<0.05);治疗后血清BNP、ATⅢ、Anti-β2-GPI水平联合预测保胎失败的AUC最大,为0.833。结论 BNP、ATⅢ、Anti-β2-GPI的表达与PTS-RSA的发生、转归有关,通过检测上述指标水平有助于预测孕妇保胎情况,指导临床调整治疗方案。

Antithrombin Ⅲ injection via the portal vein suppresses liver damage

AIM:To investigate the effects of antithrombin Ⅲ(AT Ⅲ) injection via the portal vein in acute liver failure.METHODS:Thirty rats were intraperitoneally challenged with lipopolysaccharide(LPS) and D-galactosamine(GalN) and divided into three groups:a control group;a group injected with AT Ⅲ via the tail vein;and a group injected with AT Ⅲ via the portal vein.AT Ⅲ(50 U/kg body weight) was administrated 1 h after challenge with LPS and GalN.Serum levels of inflammatory cytokines and fibrin degradation products,hepatic fibrin deposition,and hepatic mRNA expression of hypoxiarelated genes were analyzed.RESULTS:Serum levels of alanine aminotransferase,tumor necrosis factor-α and interleukin-6 decreased significantly following portal vein AT Ⅲ injection compared with tail vein injection,and control rats.Portal vein AT Ⅲ injection reduced liver cell destruction and decreased hepatic fibrin deposition.This treatment also significantly reduced hepatic mRNA expression of lactate dehydrogenase and heme oxygenase-1.CONCLUSION:A clinically acceptable dose of AT Ⅲ injection into the portal vein suppressed liver damage,probably through its enhanced anticoagulant and antiinflammatory activities.

Removal of Bi(Ⅲ) with Adsorption Technique Using Coconut Shell Activated Carbon

In present study,we report the preparation of coconut shell activated carbon as adsorbent and its appli-cation for Bi(Ⅲ) removal from aqueous solutions.The developed adsorbent was characterized with scanning elec-tron microscope(SEM),Fourier Transform Infrared(FTIR),C,H,N,S analyzer,and BET surface area analyzer.The parameters examined include agitation time,initial concentration of Bi(Ⅲ),adsorbent dose and temperature.The maximum adsorption of Bi(Ⅲ)(98.72%) was observed at 250 mg·L-1 of Bi(Ⅲ) and adsorbent dose of 0.7 g when agitation was at 160 r·min-1 for 240 min at(299±2) K.The thermodynamic parameters such as Gibb's free energy(△Gθ),enthalpy(△Hθ) and entropy(△Sθ) were evaluated.For the isotherm models applied to adsorption study,the Langmuir isotherm model fits better than the Freundlich isotherm.The maximum adsorption capacity from the Langmuir isotherm was 54.35 mg?g?1 of Bi(Ⅲ).The kinetic study of the adsorption shows that the pseudo second order model is more appropriate than the pseudo first order model.The result shows that,coconut shell ac-tivated carbon is an effective adsorbent to remove Bi(Ⅲ) from aqueous solutions with good adsorption capacity.

血清AT-Ⅲ、G6PD检测对新生儿败血症早期诊断及预后评估的价值分析

目的:通过检测新生儿败血症患儿血清中的抗凝血酶-Ⅲ(AT-Ⅲ)、6-磷酸葡萄糖脱氢酶(G6PD)表达水平,分析其在新生儿败血症的早期诊断及与预后评估的价值。方法:选取2018年1月至2020年1月确诊的新生儿败血症患儿77例为败血症组,确诊的细菌感染非败血症患儿50例为感染组,同时选取健康新生儿100名为对照组。采用发色底物法检测血清AT-Ⅲ的表达水平,简易比色法检测血清中G6PD的表达水平,全自动生化分析仪测定被试者血清中降钙素原(PCT)、白细胞计数(WBC),记录新生儿疾病危重评分(NCIS评分)。比较败血症组、感染组、对照组以及败血症患儿生存组与病死组患儿血清中AT-Ⅲ、G6PD表达水平的差异。分析血清AT-Ⅲ、G6PD表达水平对新生儿败血症及病死的诊断价值,确定影响新生儿败血症患儿病死的危险因素。结果:与对照组相比,感染组、败血症组血清AT-Ⅲ、G6PD表达水平均显著降低,且败血症组血清AT-Ⅲ、G6PD表达水平低于感染组,差异均有统计学意义(P<0.01)。血清AT-Ⅲ、G6PD水平对新生儿败血症的早期诊断曲线下面积(AUC)分别为0.811(95%CI:0.748~0.874)、0.847(95%CI:0.788~0.905)。与生存组相比,病死组新生儿血清中PCT、WBC水平均显著升高,NCIS评分、血清中AT-Ⅲ及G6PD表达水平均显著降低,差异有统计学意义(P<0.05~P<0.01)。血清AT-Ⅲ、G6PD水平检测诊断新生儿败血症病死的AUC分别为0.791(95%CI:0.671~0.911)、0.800(95%CI:0.678~0.922)。logistic回归分析结果表明,AT-Ⅲ、G6PD表达水平的降低是新生儿败血症病死的危险因素。结论:血清AT-Ⅲ和G6PD表达水平升高与新生儿败血症的发病及其不良预后联系密切,对新生儿败血症早期鉴别及不良预后的评估具有一定的价值。

Impact of antithrombin Ⅲ on hepatic and intestinal microcirculation in experimental liver cirrhosis and bowel inflammation: An in vivo analysis

AIM： To analyze the hepatic and intestinal microcirculation in an animal model of liver cirrhosis and inflammatory bowel disease （IBD） and to characterize bhe anti-inflammatory action of antithrombin Ⅲ （ATⅢ） on leukocyte kinetics and liver damage. METHODS： Hepatic and intestinal microcirculation was investigated by intravital videomicroscopy. Standardized models of experimental chronic liver cirrhosis and bowel inflammation were employed. Animals were divided into four groups （n = 6/group）： controls, animals with cirrhosis, animals with cirrhosis and IBD, animals with cirrhosis and IBD treated with ATIII. RESULTS： Cirrhosis facilitated leukocyte rolling and sticking in hepatic sinusoids （1.91±0.28 sticker/μm vs 0.5±0.5 sticker/μm in controls, P〈0.05）. The effect enhanced in animals with cirrhosis and IBD （5.4±1.65 sticker/μm）, but reversed after ATIII application （3.97±1.04 sticker/μm, P〈0.05）. Mucosal blood flow showed no differences in cirrhotic animals and controls （5.3±0.31 nL/min vs5.4±0.25 nL/min） and was attenuated in animals wibh cirrhosis and IBD significantly （3.49±0.6 nL/min）. This effect was normalized in the treatment group （5.13±0.4 nL/min, P〈0.05）. Enzyme values rose during development of cirrhosis and bowel inflammation, and reduced after ATIII application （P〈0.05）. CONCLUSION： Liver cirrhosis in the presence of IBD leads to a significant reduction in mucosal blood flow and an increase in hepatic leukocyte adherence with consecutive liver injury, which can be prevented by administration of ATⅢ.

抗凝血酶Ⅲ活性联合常规凝血指标预测深静脉血栓形成的应用价值

目的探讨血浆抗凝血酶Ⅲ(ATⅢ)活性联合常规凝血指标检测在深静脉血栓形成(DVT)患者中的应用价值。方法本研究为回顾性研究。收集2021年1—12月在南阳市中心医院血管外科确诊的163例DVT患者(其中125例为初诊DVT患者,38例为取静脉滤器患者)作为病例组,同期137例健康正常人为对照组。DVT组中男性78例,女性85例,年龄(56.56±13.49)岁;对照组中男性92例,女性45例,年龄(42.31±10.32)岁。采用独立样本t检验或Mann-Whitney U检验比较ATⅢ等计量资料在不同人群或DVT亚组中的差异;采用χ2检验比较性别等计数资料。对DVT组与对照组的相关检测指标进行Fisher判别分析,利用受试者工作特征曲线评估ATⅢ活性降低在DVT事件中诊断效能,采用logistic回归分析DVT事件的危险因素。结果DVT组的ATⅢ活性低于对照组[(89.79±11.08)%比(96.52±8.28)%,t=37.895,P<0.001]。ATⅢ减低组(ATⅢ≤80%)患者合并手术史、心脑血管疾病史的比例高于ATⅢ正常组[71.43%(20/28)比47.42%(46/97),71.43%(20/28)比48.45%(47/97),χ2=5.024、4.612,均P<0.05]。Fisher判别函数评估ATⅢ水平联合传统凝血指标在甄别DVT中的应用:健康对照组Y1=0.114×年龄+1.742×凝血酶原时间-0.176×活化部分凝血活酶时间+6.479×凝血酶时间+7.798×纤维蛋白原-0.378×D-二聚体+0.021×血小板计数+1.035×ATⅢ-132.585;DVT组Y2=0.203×年龄+1.949×凝血酶原时间-0.161×活化部分凝血活酶时间+6.246×凝血酶时间+8.158×纤维蛋白原+0.105×D-二聚体+0.018×血小板计数+0.937×ATⅢ-127.587,总符合率为85.11%(223/262)。ATⅢ判断DVT事件的曲线下面积为0.706,截断值为86.5%,灵敏度和特异度分别为46.77%和91.24%。在调整了性别和年龄后,ATⅢ<86.5%是发生DVT事件的最主要独立危险因素(优势比=10.460,95%可信区间为4.676~23.400)。结论DVT患者的ATⅢ水平显著降低,ATⅢ联合常规凝血指标有助于甄别DVT事件。ATⅢ<86.5%是发生DVT事件的主要独立危险因素,应警惕ATⅢ水平降低人群的静脉血栓形成风险。

血清抗凝血酶-Ⅲ联合改良CT严重指数评估急性胰腺炎患者病情严重程度及预后的临床价值

目的研究血清抗凝血酶-Ⅲ(AT-Ⅲ)联合改良CT严重指数(MCTSI)对急性胰腺炎(AP)患者病情严重程度及预后评估的临床价值。方法以回顾性分析为法,观察对象为2017年1月至2023年1月入皖南医学院第二附属医院的62例AP患者,参考病情严重程度分为轻度组(n=19)、中度组(n=23)和重度组(n=20);同时参考预后情况分为存活组(n=55)与死亡组(n=7)。比较不同组别患者的血清AT-Ⅲ水平与MCTSI评分,并采用受试者工作特征(ROC)曲线评估血清AT-Ⅲ联合MCTSI诊断重度AP及预测AP患者死亡的临床价值。结果重度组患者血清AT-Ⅲ水平为(131.54±36.19)mg/L,明显低于轻、中度组[(255.91±61.36)、(186.75±43.28)mg/L],MCTSI评分为(7.18±1.52)分,明显高于轻、中度组[(3.71±0.68)、(5.11±1.09)分],差异均有统计学意义(P<0.05);中度组患者血清AT-Ⅲ水平明显低于轻度组,MCTSI评分明显高于轻度组,差异均有统计学意义(P<0.05)。死亡组患者血清AT-Ⅲ水平为(100.96±32.43)mg/L,明显低于存活组[(194.05±72.97)mg/L],MCTSI评分为(8.02±1.24)分,明显高于存活组[(4.81±1.52)分],差异均有统计学意义(P<0.05)。ROC曲线分析显示,重度AP诊断中血清AT-Ⅲ水平联合MCTSI评分的敏感度、特异度、曲线下面积(AUC)明显优于单一指标检测,差异均有统计学意义(P<0.05)。ROC曲线分析显示,血清AT-Ⅲ水平联合MCTSI评分预测AP患者死亡的敏感度、特异度、AUC明显优于单一指标检测,差异均有统计学意义(P<0.05)。结论血清AT-Ⅲ联合MCTSI在AP患者病情严重程度及预后评估中具有较高的临床价值。

HBV相关慢加急性肝衰竭患者血清GP73、suPAR和AT-Ⅲ水平变化及其临床意义探讨

目的探讨乙型肝炎病毒相关性慢加急性肝衰竭(HBV-ACLF)患者血清高尔基体蛋白73(GP73)、可溶性人尿激酶型纤溶酶原激活物受体(suPAR)和抗凝血酶-Ⅲ(AT-Ⅲ)水平变化及其临床意义。方法2019年11月~2022年10月我院收治的HBV-ACLF患者81例(早期29例,中期28例,晚期24例)和慢性乙型肝炎(CHB)患者65例,采用ELISA法检测血清GP73、suPAR和AT-Ⅲ水平。应用受试者工作特征曲线(ROC)评估各指标评估疾病预后的价值。结果HBV-ACLF患者血清GP73和suPAR水平分别为(227.4±48.4)ng/mL和(8.3±2.3)ng/mL,显著高于CHB患者【分别为(126.6±31.6)ng/mL和(5.1±1.6)ng/mL,P<0.05】,而血清AT-Ⅲ水平为(48.2±12.9)%,显著低于CHB患者【(76.6±18.7)%,P<0.05】;晚期HBV-ACLF患者血清GP73和suPAR水平分别为(265.6±27.1)ng/mL和(9.4±1.2)n g/mL,显著高于中期患者【分别为(231.7±29.5)ng/mL和(8.4±1.4)ng/mL,P<0.05】或早期患者【分别为(191.6±33.5)ng/mL和(7.3±1.6)ng/mL,P<0.05】,而血清AT-Ⅲ水平为(36.8±9.1)%,显著低于中期患者【(47.1±10.9)%,P<0.05】或早期患者【58.7±11.3)%,P<0.05】;在治疗3个月末,本组ACLF患者生存59例(72.8%),死亡22例(27.2%);死亡组血清GP73和suPAR水平分别为(270.4±38.3)ng/mL和(9.9±6.2)ng/mL,显著高于生存组【分别为(210.9±41.5)ng/mL和(8.0±1.5)ng/mL,P<0.05】,而血清AT-Ⅲ水平为(35.4±9.1)%,显著低于生存组【(51.1±10.6)%,P<0.05】;联合检测HBV-ACLF患者血清GP73、suPAR和AT-Ⅲ水平预测短期死亡的AUC为0.846,显著优于三项指标单独评估(其AUC分别为0.703、0.710和0.744,P<0.05),其灵敏度、特异度和准确度分别为81.8%、81.4%和81.5%。结论监测HBV-ACLF患者血清GP73、suPAR和AT-Ⅲ水平可能有助于评估预后,值得进一步研究。