血浆AT3、PC、PS水平与静脉血栓栓塞症患者发病的相关性分析
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摘要
目的血浆AT3、PC、PS水平与静脉血栓栓塞症(VTE)患者发病的相关性研究。方法选取2016年7月—2017年6月在本院接受治疗的170例VTE患者作为观察组,对其资料进行回顾性分析。另选取同时期本院进行全身体检的100例健康人员作为正常对照组,比较两组人员AT3、PC、PS遗传因素、血浆水平和活性的差异。结果两组患者遗传性危险因素对比分析,结果显示正常对照组无抗凝蛋白缺乏现象,观察组PS缺乏情况最多,占比20.6%,除"PS、AT3同时缺乏"项外,其它指标均明显高于对照组,P<0.05,差异有统计学意义。比较两组人员血浆AT3、PC、PS水平,结果显示观察组三项指标均明显低于对照组,P<0.05,差异有统计学意义。两组血浆PC及PS活性比较,观察组较对照组活性均明显降低降低,P<0.05,差异有统计学意义。对三个危险因素进行logistic回归性分析,发现血浆PS、AT3的活性与VTE的发生呈现负相关,即随着血浆PS、AT3的降低,VTE发生的几率升高,而PC的改变对VTE的发生无明显影响。结论血浆AT3、PC及PS水平与VTE的发生呈负相关性,其血浆水平的降低是导致VTE发生的危险因素之一,监测其血浆水平的变化对于预防和诊断VTE有重要的意义。
Objective To explore the relationship among plasma AT3,PC,PS level and the incidence of venous thromboembolism( VET).Methods 170 VET patients treated in our hospital from July 2016 to June2017 were selected as observation group,and their data were analyzed retrospectively. In addition,100 healthy persons who underwent physical examination in our hospital during the same period were selected as the normal control group. Compared the genetic factors,plasma levels and activities of AT3, PC and PS. Results Comparison of two groups of patients with hereditary risk factors,the results showed that normal control group without any anticoagulant protein deficiency,PS deficiency was the main deficiency in the observation group,accounting for 20.6%,all the hereditary risk factors of observation group were significantly higher than control group except the PS & AT3 simultaneous deficiency,there were significant differences between the two groups( P<0.05). The concentrations of plasma AT3,PC and PS in observation group were significantly lower than the control group( P<0.05).PC and PS activity of the control group was higher compared with the observation group,and there was statistical significant( P<0.05).The activity of PS and AT3 negatively correlated to the incidence of venous thromboembolism.Conclusions Plasma AT3,PC,PS levels were directly correlated with the incidence of venous thromboembolism,they may be the risk factors of venous thromboembolism,monitoring the change of its level has important significance for the diagnosis and prevention of venous thromboembolism.
Objective To explore the relationship among plasma AT3,PC,PS level and the incidence of venous thromboembolism( VET).Methods 170 VET patients treated in our hospital from July 2016 to June2017 were selected as observation group,and their data were analyzed retrospectively. In addition,100 healthy persons who underwent physical examination in our hospital during the same period were selected as the normal control group. Compared the genetic factors,plasma levels and activities of AT3, PC and PS. Results Comparison of two groups of patients with hereditary risk factors,the results showed that normal control group without any anticoagulant protein deficiency,PS deficiency was the main deficiency in the observation group,accounting for 20.6%,all the hereditary risk factors of observation group were significantly higher than control group except the PS & AT3 simultaneous deficiency,there were significant differences between the two groups( P<0.05). The concentrations of plasma AT3,PC and PS in observation group were significantly lower than the control group( P<0.05).PC and PS activity of the control group was higher compared with the observation group,and there was statistical significant( P<0.05).The activity of PS and AT3 negatively correlated to the incidence of venous thromboembolism.Conclusions Plasma AT3,PC,PS levels were directly correlated with the incidence of venous thromboembolism,they may be the risk factors of venous thromboembolism,monitoring the change of its level has important significance for the diagnosis and prevention of venous thromboembolism.
引文
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[2]王思广.凝血因子FX和抗凝蛋白PC水平检测在急性静脉血栓栓塞症中的临床意义[J].航空航天医学杂志,2014,12(2):160-161.
[3]黄俊伟,张晨,张尉华,等.肺血栓栓塞症患者相关危险因素[J].中国老年学杂志,2015,8(6):1532-1534.
[4]郭元元,白垚,周窈佳,等.血浆蛋白C和蛋白S在静脉血栓栓塞患者体内的表达及意义[J].检验医学与临床,2016,13(6):815-816.
[5]邸平,梁臻龙,徐丽娟,等.静脉血栓栓塞症患者及脑梗塞患者易栓因素研究[J].血栓与止血学,2016,22(6):630-632.
[6]刘芳,诸兰艳,陈平,等.蛋白C、蛋白S缺乏症相关肺动脉血栓栓塞2例并文献复习[J].中南大学学报(医学版),2013,38(9):971-976.
[7]邸平.中国易栓人群抗凝蛋白缺陷与血栓形成易感性的研究[D].中国人民解放军总医院;解放军医学院,2016:1-50.
[8]门剑龙,钟殿胜,任静,等.血栓标志物评估恶性肿瘤患者静脉血栓风险[J].中华肿瘤杂志,2015,9(4):283-289.
[9]张岚,邓昊昱,谢君,等.蛋白C错义突变Met406Ile致静脉血栓栓塞症的遗传表型及蛋白结构分析[J].中华医学杂志,2013,93(29):2275-2278.
[10]赵小军,魏娟,王建云,等.血栓标志物对恶性肿瘤患者发生静脉血栓的风险评估效果[J].中国现代医学杂志,2015,25(36):58-63.