深静脉血栓形成患者凝血、抗凝、纤溶系统功能改变及临床意义

目的:通过观察深静脉血栓形成(DVT)患者凝血、抗凝和纤溶系统各项指标的变化,探讨高凝状态在DVT发病机制中的重要作用,指导临床采用合理的预防及治疗措施。方法:以60例健康查体者作为对照组,测定60例DVT患者的血小板数量(BPC)、血小板聚集率(PAgT)、血小板α颗粒膜蛋白(GMP-140)含量;血浆凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(ATPP)、纤维蛋白原(Fg)、血管性血友病因子(vWF)含量;抗凝血酶Ⅲ(AT-Ⅲ)、蛋白C(PC)活性、蛋白S(PS)含量;纤溶酶原(PIg)、组织型纤溶酶原激活物活性(tPA)及纤溶酶原激活物抑制物-1(PAI-1)活性。结果:与正常对照组相比,DVT患者PAgT、GMP-140、Fg、vWF含量及PAI-1活性明显升高:PT、TT、APTT、AT-Ⅲ、PC、PS、PIg及tPA活性水平均明显降低(均P<0.01)。结论:血液凝血、抗凝和纤溶活性异常所致的高凝状态在DVT发病机制中占有重要地位,临床应采用凝血、抗凝和纤溶联合指标指导DVT的防治,以取得最佳效果。

The Study on the Coagulant, Anticoagulant and Fibrinolytic Function change in Patients with Deep Venous Thrombosis

Objective:Coagulant,anticoagulant and fibrinolytic function of patients with deep venous thrombosis,were assayed.To detemine the important role of hypercoagulation in development of this disease.Methods:60 DVT patients and 60 normal controls were studied. All patients were evaluated respectively by examining their blood BPC,PagT,GMP-140,PT,TT,APTT,Fg,VWF,AT-Ⅲ,PC,PS,PIg,tPA-A and PAI-1. Result: The level of PagT,GMP-140,Fg,VWF及PAI-1,in DVT group are higher than normal control group. The level of PT,TT,APTT,AT-Ⅲ,PC,PS,PIg and tPA in DVT group are significantly lowe, than in normal control group(all P<0.01).Conclusion:Hypercoagulation is the most important factor in development of DVT patients. The level of coagulant,anticoagulant and fibrinolytic function can be adopted to assay the clinical therapy effect.