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目的:探讨血栓患者与高同型半胱氨酸血症(HHcy)、活化蛋白C抗性(APCR)及凝血因子v基因多态性的关系。方法:300例健康查体者为正常对照;纳入研究的223例血栓患者中,经计算机断层显像(CT)的脑梗塞(CI)80例、心肌梗塞(MI)82例和静脉血栓栓塞(VTE)61例;另纳入研究的270例血栓前状态患者中,妊高症(PTH)76例、慢性阻塞性肺疾病(COPD)62例、糖尿病(DM)60例和癌症(CA)72例。以循环酶法和APTT凝固法分别测定病例组和正常对照血浆中HHcy及APCR,并用限制性内切酶片段多态性(RFLP)测定FV G1691-A、G1091-C、A1090-G等3种基因多态性的发生情况。结果:静脉血栓患者APCR阳性率最高(62.29%),正常对照组APCR阳性很低(7.33%),而其HHcy阳性分别为68.42%及10.00%。发现3例FV基因杂合突变静脉血栓患者为APCR阳性。结论:静脉血栓患者HHcy阳性率明显高于正常对照,HHcy是引起静脉血栓患者血栓形成的重要原因之一,静脉血栓患者存在APCR,而APCR阳性可能与凝血因子V基因多态性有关。
Objective: To investigate the relationship between thrombosis and hyperhomocysteinemia (HHcy), activated protein C resistance (APCR) and clotting factor v gene polymorphism. Methods: A total of 300 healthy subjects were included in the study. Totally 223 patients with thrombus were enrolled in this study. Eighty patients with cerebral infarction (CI), 82 with myocardial infarction (MI) and venous thromboembolism (N = 61). Among the 270 prethrombotic patients enrolled in the study, there were 76 cases of pregnancy induced hypertension (PTH), 62 cases of chronic obstructive pulmonary disease (COPD), 60 cases of diabetes mellitus (DM) and 72 cases of cancer . The HHcy and APCR in the plasma of patients and normal controls were determined by cyclase and APTT coagulation and three kinds of FV G1691-A, G1091-C and A1090-G were determined by restriction fragment analysis (RFLP) Gene polymorphism of the situation. Results: The positive rate of APCR in patients with venous thrombosis was the highest (62.29%). The positive rate of APCR in the control group was very low (7.33%), while the positive rate of HHcy was 68.42% and 10.00% respectively. Three patients with VV heterozygous mutation venous thrombosis were found to be APCR positive. Conclusion: The positive rate of HHcy in patients with venous thrombosis is significantly higher than that of normal controls. HHcy is one of the important causes of thrombosis in patients with venous thrombosis. There is APCR in patients with venous thrombosis, while the positive of APCR may be related to the polymorphism of factor V gene.