摘要
目的探讨肺血栓栓塞症(PTE)患者体内凝血纤溶系统及肺血管内皮功能的变化及其临床意义。方法采用酶联免疫吸附测定(ELISA)检测80例PTE患者(急性大面积PTE组20例、非大面积PTE组60例)、40名正常人(对照组)的血D-二聚体(D-D)、组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活剂抑制物1(PAI-1)、血浆蛋白S(Ps)、血浆蛋白C(Pc)、凝血酶调节蛋白(TM)、抗心磷脂抗体(ACA)、同型半胱氨酸(Hcy)含量;采用发色底物法检测抗凝血酶Ⅲ活性(AT-Ⅲ)。结果急性大面积PTE组患者血D-D、t-PA、PAI-1、Ps、TM、含量分别为(1.46±0.62)mg/L、(11.4±6.9)μg/L、(88.2±27.5)μg/L、(22.40±9.40)mg/L、(6.8±1.1)μg/L,非大面积PTE组分别是(0.92±0.27)mg/L、(6.6±1.5)μg/L、(60.1±26.1)μg/L、(23.90±10.70)mg/L、(6.3±1.5)μg/L,均显著高于正常对照组的(0.38±0.10)mg/L、(4.7±1.4)μg/L、(35.7±9.2)μg/L、(16.10±6.20)mg/L、(3.0±0.5)μg/L(分别P<0.01、<0.05)。急性大面积PTE组患者血AT-Ⅲ含量为(86.0±11.8)%,非大面积PTE组为(90.1±9.0)%,显著低于正常对照组的(102.6±9.20)%(P分别<0.01、0.05)。两PET组患者ACA-IgG、IgM、IgA显著高于正常对照组,差异有统计学意义(P<0.05)。结论PTE患者存在凝血纤溶系统功能失衡和肺血管内皮损伤。
Objective To explore the changes of blood coagulative and fibrinolytic systems and functions of pulmonary vascular endothelium in patients with pulmonary thromboembolism（PTE）. Methods Twenty patients with acute massive PTE, 40 patients with acute non-massive PTE and 40 control subjects without PTE were included in the study. D-Dimer （ D-D ）, tissue-type plasminogen activator （ t-PA ）, plasminogen activator inhibitorl （PAI-1）, plasma protein S （Ps）, plasma protein C （Pc）, thrombomodulin （TM）, anticardiolipin antibody（ACA） and homocysteine （Hcy） were measured by the method of ELISA. Antithrombin-Ⅲ （AT-Ⅲ ） activity was measured by chromo-substrate method. Results The levels of D-D, t-PA,PAI-1, and TM were （1.46±0.62） mg/L, （11.4±6.9）μg/L, （88.2 ±27.5）μg/L, （6.8 ± 1.1 ）μg/L respectively in patients with acute massive PTE and （ 0.92 ± 0. 27 ） mg/L, （6.6 ± 1.5 ）μg/L, （60. 1 ± 26.1 ）μg/L, and （6.30 ± 1.50） mg/L in patients with acute non-massive PTE. The levels of both PET groups were significantly higher than those of the control subjects [ （0.38 ± 0. 10） mg/L , （4.7 ± 1.4）μg/L , （35.7 ± 9.2）μg/L, （ 3.0 ± 0.5 ） μg/L and P 〈 0.05 ]. The levels of AT- Ⅲ were （ 86.0 ± 11.8 ）% in patients with acute massive PTE and （90.1 ± 9.0）% in patients with acute non-massive PTE. The levels of AT-Ill in both groups were significantly lower than those of the control subjects, which were （102.6 ± 9.2）% （P 〈0.01 and P 〈 0.05 respectively）. The levels of ACA-IgG, IgM and IgA in patients with acute massive PTE and non-massive PTE were also significantly higher than those in the control group （P 〈 O. 05 ）. Conclusion Imbalance of blood coagulation and fibrolytic systems and pulmonary vascular endothelium damage occur in patients with PTE.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2005年第10期714-716,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
"十五"国家科技攻关资助项目(2001BA703B15)
