纤溶酶-a2纤溶酶抑制物复合物凝血酶抗凝血酶复合物血栓调节蛋白测定弥散性血管内凝血早期诊断中的意义
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摘要
目的探讨纤溶酶-a2纤溶酶抑制物复合物(PAP),凝血酶抗凝血酶复合物(TAT),血栓调节蛋白(TM)在弥散性血管内凝血(DIC)早期诊断中的临床意义。方法根据患者病程分为早期DIC组29例、DIC组34例,用化学发光法检测PAP、TAT和TM量,并与32名健康人对照。结果 DIC早期组与DIC组PAP、TAT、TM高于健康对照组,差异有统计学意义(P<0.05)。DIC组与DIC早期相比,PAP、TAT、TM升高,差异有统计学意义(P<0.05)。结论PAP、TAT和TM是反映体内凝血、抗凝及纤溶系统激活的敏感性指标,对DIC早期诊断具有实用价值。
Objective To study the clinical significance of plasmin-alpha 2-antiplasmin complex(PAP),thrombin-antithrombin-Ⅲ complex(TAT) and Thrombomoduline(TM) in early diagnosis of disseminated intravascularcoagulation(DIC). Methods According to the course,The patients were divided into pre-DIC group(29 cases)and DICgroup(34 cases),32 healthy people were enrolled as the control group. PAP,TAT and TM were measured by che-miluminescence method. Results The PAP,TAT and TM in the pre-DIC group and the DIC group were significantlyhigher than that of healthy group(P<0.05),PAP,TAT and TM were significantly increased in the DIC group comparedwith the pre-DIC(P<0.05). Conclusion PAP,TAT and TM reflecting the activation of coagulation,anticoagulation andfibrinolytic system are sensitive indicators. They have practical value for the early diagnosis of DIC.
Objective To study the clinical significance of plasmin-alpha 2-antiplasmin complex(PAP),thrombin-antithrombin-Ⅲ complex(TAT) and Thrombomoduline(TM) in early diagnosis of disseminated intravascularcoagulation(DIC). Methods According to the course,The patients were divided into pre-DIC group(29 cases)and DICgroup(34 cases),32 healthy people were enrolled as the control group. PAP,TAT and TM were measured by che-miluminescence method. Results The PAP,TAT and TM in the pre-DIC group and the DIC group were significantlyhigher than that of healthy group(P<0.05),PAP,TAT and TM were significantly increased in the DIC group comparedwith the pre-DIC(P<0.05). Conclusion PAP,TAT and TM reflecting the activation of coagulation,anticoagulation andfibrinolytic system are sensitive indicators. They have practical value for the early diagnosis of DIC.
引文
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[2] Saracco P,Vitale P,Scolfaro C,et al. The coagulopathy in sep-sis:significance and implications for treatment[J]. Pediatr Rep,2011,3(4):e30.
[3]中华血液学杂志编辑部.第七届全国血栓与止血学术会议制定的几项诊断参考标准[J].中华血液学杂志,2000,21(3):165-168.
[4] Watanabe R,Wada H,Watanabe Y,et al. Activity and antigenlevels of thrombin-activatable fibrinolysis inhibitor in plasma ofpatients with disseminated intravascular coagulation[J]. ThrombRes,2001,104(1):1-6.
[5] Lee SY,Niikura T,Iwakura T,et al. Thrombin-antithrombinⅢcomplex tests[J]. J Orthop Surg(Hong Kong),2017,25(1):16.
[6]刘敏涓,刘泽霖.关于DIC的定义,临床,实验室标准与其计分系统[J].血栓与止血学,2002,8(2):85-86.
[7]王学文.日本弥散性血管内凝血治疗指南解读[J].中国危重病急救医学,2009,21(8):451-454.
[8]邢迎红,曹书华,沈中华.血栓调节蛋白在弥散性血管内凝血中的意义[J].中国急救医学,2002,22(1):33-34.
[9] Kario K, Matsuo T, Kodama K, et al. Imbalance betweenthrombin and plasmin activity in disseminated intravascularcoagulation. Assessment by the thrombin-antithrombin-Ⅲcom-plex/plasmin-alpha-2-antiplasmin complex ratio[J]. Haemostasis,1992,22(4):179-186.
[10]万楚成,夏云金,章正华,等.止凝血分子标志物在急性白血病合并DIC中的意义[J].临床内科杂志,2007,24(8):549-551.
[11]吴方,王学锋,璩斌,等.急性白血病并发前DIC的分子标志物诊断[J].上海医学,2002,25(3):164-166.
[12] Park KJ,Kim HJ,Hwang SC,et al. The imbalance betweencoagulation and fibrinolysis is related to the severity of the ill-ness and the prognosis in sepsis[J]. Korean J Intern Med,1999,14(2):72-77.