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为探讨口服华法令抗凝中出血和血栓发生的机制，实验观察了蛋白Ｃ（ＰＣ）和抗凝血酶Ⅲ（ＡＴⅢ）在其中的变化。选择２０例风湿性心脏病择期行机械“瓣膜替换”术的患者，测定其术前、术后１４ｄ血液中ＰＣ和ＡＴⅢ的变化，与同时测定的尿纤维蛋白肽Ａ（ＦＰＡ）含量和凝血酶原时间（ＰＴ）进行比较。另选２０例换瓣３月～２年口服华法令抗凝的患者为随访组，对照组为１０例健康志愿者。实验发现风湿性心脏瓣膜病术前ＰＣ（４．２±１．２）ｇ／ｍｌ和ＡＴⅢ（１２８．１±２３．１）％均低于对照组，ＦＰＡ（７４．２±７．２）ｎｇ／ｍｇＣｒ则高于对照组，瓣膜替换术后１４ｄ，ＰＴ值均在１８～２４ｓ，ＡＴⅢ（７２．０±６．８）％和ＦＰＡ（１２．１±３．８）ｎｇ／ｍｇＣｒ较术前降低，而ＰＣ较术前无显著变化；随访组ＦＰＡ（２．１±１．１）ｎｇ／ｍｇＣｒ和ＰＣ（３．２±０．９）ｇ／ｍｌ比术后１４ｄ水平显著降低，而ＡＴⅢ却高于对照组。ＡＴⅢ和ＰＣ的变化可能是华法令抗凝中出血和血栓并发症的因素之一
To investigate the mechanism of bleeding and thrombosis during warfarin oral administration, the changes of protein C (PC) and antithrombin Ⅲ (AT Ⅲ) were observed. Twenty patients with rheumatic heart disease undergoing elective valve replacement surgery were enrolled. The changes of PC and ATⅢ in the blood before and 14 days after operation were measured, and the levels of urinary fibrinolipid A (FPA) and thrombin The original time (PT) is compared. Another 20 cases of valve replacement for 3 months to 2 years of oral warfarin anticoagulant patients for the follow-up group, the control group of 10 healthy volunteers. The results showed that preoperative PC (4.2 ± 1.2) g / ml and ATⅢ (128.1 ± 23.1)% were significantly lower in rheumatic heart valve disease than in control group, FPA was (74.2 ± 7.2) ng / mgCr was higher than that of the control group. The values of PT were all 18 ~ 24s after operation 14 days after valve replacement. The AT (72.0 ± 6.8)% and FPA (12.1 ± 3.8) ng / (P <0.01), but the level of PC in the follow-up group was significantly lower than that at the 14th postoperative day (FPA 2.1 ± 1.1 ng / mgCr and PC 3.2 ± 0.9 g / ml) AT Ⅲ is higher than the control group. Changes in AT III and PC may be one of the causes of bleeding and thromboembolic complications in warfarin anticoagulation