摘要
目的 探讨血栓形成前血管内皮细胞、血小板、凝血、抗凝、纤溶系统等多种因素改变的综合作用,寻找特异、敏感的指标识别血栓前状态。方法 将创伤骨折患者40例,DVT患者10例及40例正常人血浆标本按对照、创伤手术后、DVT及同一组患者手术前后进行分组,用放免、酶免及ACL血凝仪分别测定血浆α-颗粒膜蛋白(GMP-140)、血栓烷(TXB_2)、6-酮-前列腺素_(1α)、凝血酶时间(PT)、部分活化凝血酶元时间(APTT)、纤维蛋白元(FIB)、D-二聚体(D-D)等指标。结果 创伤组、DVT组与对照组比较GMP-140、TXB_2、FIB、D-二聚体有显著增高,6-Keto-PGF_(1α)有显著下降;APTT、PT的变化不明显。创伤后同一组患者手术前后比较,GMP-140、TXB_2、D-二聚体三项指标差异有显著性(P<0.05)。其它几项指标手术前后无显著性差异。GMP-140、TXB_2、D-二聚体三项指标对不同骨折患者检测阳性率差异无显著性。结论 创伤会造成血小板活化与血管内皮细胞损伤,监测GMP-140、TXB_2、6-酮-前列腺素_(1α)等指标可以对血栓前状态(高凝状态)生理性防御反映阶段进行早期预防。
Objective To evaluate the clinical significance of human plasma GMP-140,TXB2,6-Keto-PGF1a ,PT,APTT,FUKD-Dimer level for the diagnosis of prethrombotic state in trauma patient Methods 90 cases were divided into normal control group, trauma post-operative group and DVT group. Plasma GMP-140, TXB2,-Keto-PGF1a.PT.APTT.FIB,D-Dimer level were measured by RIA.ELISA and ACL-200. Results Compared with the control group, GMP-140,TXB2 ., FIB, D-Dimer leve were significantly higher, 6-Keto-PGF1a were significantly lower in the post-operative and DVT group, while APTT and PT did not changes obviously in all groups. Comparison between preoperative and postoperative of the trauma patients showed significant different in GMP-140,TXB2,D-Dimer leve (P<0.05),not for others index.The positive rate of examining GMP-140,TXB2,ND-Dimer in trauma patients did not show difference. Conclusion Thrombocyte activation and endothelial cell injury may be cause by trauma, the measurement of this index is valuable for the diagnosis and prevention of prethrombotic state.
出处
《中国骨伤》
CAS
2003年第4期202-205,共4页
China Journal of Orthopaedics and Traumatology
