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目的 探讨中国静脉血栓患者抗凝蛋白缺陷发生率。方法 87例非急性期且无获得性抗凝蛋白缺陷的深静脉血栓患者分别测定血浆抗凝血酶Ⅲ (ATⅢ )、蛋白C (PC)、蛋白S(PS)水平和活化蛋白C敏感比值 (APC SR) ,并对获得性狼疮抗凝物 (LA)和抗心磷脂抗体 (ACL)进行检测。用PCR 限制性片段长度多态性 (PCR RFLP)方法检测FV Leiden变异。结果 2 5例患者有抗凝蛋白缺陷 :ATⅢ缺陷 3例 ,PC缺陷 5例 ,PS缺陷 10例 ,活化蛋白C抵抗 (APC R) 2例 ,ATⅢ +PC 1例 ,ATⅢ +PS 1例 ,PC +PS 1例 ,APC R +PC1例 ,APC R +PS 1例。ATⅢ、PC和PS缺陷总发生率达 2 6 4%。抗凝蛋白缺陷患者与无缺陷患者比较 :首次发生血栓的平均年龄小 (35 2± 9 7,42 1± 10 9) (岁 ) ;(P <0 0 1) ,血栓发生次数多 (P <0 0 5 ) ,肺栓塞发生率高 (4 4 0 % ,16 1% ;P <0 0 1)。结论 中国静脉血栓患者ATⅢ、PC和PS缺陷发生率高于西方国家 ,其静脉血栓易栓症病因可能与西方国家不同。
Objective To investigate the incidence of anticoagulant defects in patients with venous thrombosis in China. Methods Eighty-seven patients with deep venous thrombosis without acute anticoagulant deficiency were tested for the levels of ATⅢ, PC (C), protein S (PS), and activated protein C APC SR) and tested for acquired lupus anticoagulant (LA) and anticardiolipin antibodies (ACLs). The FV Leiden mutation was detected by PCR restriction fragment length polymorphism (PCR RFLP). Results A total of 25 patients had anticoagulant defects: 3 cases of AT Ⅲ defect, 5 cases of PC defect, 10 cases of PS defect, 2 cases of APC R, 1 case of AT Ⅲ + PC, 1 case of AT Ⅲ PS and 1 case of PC 1 case of PS, 1 case of APC R + PC and 1 case of APC R + PS. The total incidence of AT Ⅲ, PC and PS defects reached 26.4%. The mean age of first-onset thrombosis was (35 2 ± 9 7, 42 1 ± 10 9) (years), (P 0 01), and the number of thromboses was more frequent (P < 0 0 5). The incidence of pulmonary embolism was high (44.0%, 16.1%; P <0.01). Conclusion The incidence of AT Ⅲ, PC and PS defects in patients with venous thrombosis in China is higher than that in western countries. The causes of venous thrombosis may be different from those in western countries.