血浆蛋白Z水平测定的临床观察

目的检测蛋白质Z（PZ）在重症肝病与口服华法林患者中的变化，探讨其临床意义。方法血浆PZ采用ELISA法检测，凝血因子活性FX：C和PT（INR）应用全自动血凝仪测定；对17例重症肝病、30例口服华法林和23例健康者的血浆PZ、FX：C和PT（INR）水平进行检测，并做各组相关性作比较。结果重症肝病组和口服华法林组的PZ水平分别为240．1±192．7μg/L、609．9±267．2μg/L与对照组的1812．6±34．2 μg/L比较明显下降（P值均〈0．05）；重症肝病组与口服华法林组的FX：C分别为71．4±30．2％、85．±19．5％，与对照组FX：C的110．6±17．0比较，明显下降（P〈0．05）．；而PT（INR）分别为2．22±0．97；2．45±0．63与对照组0．93±0．04比较，明显增高（P〈0．05）。结论㈦时检测PZ与PT（INR）①有助于重症肝病患者治疗的预后监控；②对口服华法林患者可能发生的出血危险性的预测有重要意义。

Detection of Plasma Protein Z Level and the Clinical Oberservation

Objective To observe the aheration of protein Z（PZ） in patients with severe hepatopethy （SH） or oral warfarin therapy （OWT） and to explore Its chinical significance. Methods PZ was measured by ELISA, plasma FX：C and PT：NR by automatic coagulation analysator. In 17 patients with Severe hepatopathy （SH.）,30 patients with oral warfarin therapy （OWT）and 23 healthy persons as contrast;plasma PZ, FX：C , and PT（INR） were measured and compared with those in different groups. Results In SH and OWT groups, PZ levels decreased significantly to 240 ± 192.7 μg/L and 609 ± 267.2 μg/L, respectively compared with 1 812.6 ± 347.2 μg/L in the contrast group. Plasma FX ： C decreasd to 71.4 ± 7.0.1% , 85.0 ± 19.5% respectively in SH and OWT,compared with those in heatthy persons 110.6 ± 17.0（P 〈 0.05 ） ; Meanwhile PT（INR） raised significantly to 2.22 ±0.79,2.45 ± 0.63. compared with contrast group（0.93 ± 0.04 ）（ P 〈 0.05）. Conclusion （1） At the same time PZ and PT（INR） may be good markers to monitor the status and evaluate the treatment of SH ; （2） Monitoring plasma PZ is significant to judge the bleeding tendency of patients with OWT.