慢性高原病患者血浆vWF、ADAM13及TSP1水平研究

发布时间：2018-03-23 10:09

本文选题：慢性高原病　切入点：血管性血友病因子　出处：《青海大学》2015年硕士论文

【摘要】：目的通过测定CMS患者血浆中血管性血友病因子(von Willebrand factor,v WF)、血管性血友病因子裂解蛋白酶(von Willebrand factor cleaving protease,v WF-CP,ADAM13)及凝血酶敏感蛋白1(thrombospondin 1,TSP1)水平,探讨v WF、ADAM13及TSPl在CMS发生中的作用,寻找敏感、有效的实验室指标对CMS的病情变化进行监测并指导临床治疗。方法采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)测定28例CMS患者、28例高原健康受试者(GY)和28例西宁健康受试者(XN)血浆v WF、ADAM13及TSP1水平。结果 1.CMS组血浆v WF水平(64.41±12.87)U/L高于高原健康组(30.64±20.26)U/L及西宁健康组(22.69±9.12)U/L(P0.05);2.CMS组血浆ADAM13水平(1.08±0.29)ng/ml与高原健康组(1.01±0.19)ng/ml均低于西宁健康组(1.27±0.30)ng/ml(P0.05);3.CMS组TSP1水平(6.94±4.78)ng/ml高于高原健康组(3.97±2.20)ng/ml及西宁健康组(2.55±2.94)ng/ml(P0.05);4.高原健康组PLT数量(275.03±33.42)×109/L较CMS组(151.92±64.59)×109/L及西宁健康组(223.67±69.24)×109/L升高(P0.05);5.CMS组PLT数量(151.92±64.59)×109/L较高原健康组(275.03±33.42)×109/L及西宁健康组(223.67±69.24)×109/L均减少(P0.05);6.CMS组PT(16.03±4.23)S较高原健康组(12.22±0.86)S及西宁健康组(12.21±1.0)S延长(P0.05);7.CMS组APTT(44.31±9.08)S及高原健康组(31.90±5.45)S均较西宁健康组(28.17±4.17)S延长(P0.05);8.CMS组PT与APTT延长呈正相关(r=0.504);高原健康组PT与APTT延长也呈正相关(r=0.430)。结论 1.CMS患者组血浆v WF水平高于高原健康组及西宁健康组,ADAM13水平均低于西宁健康组,CMS组TSP1水平高于高原健康组及西宁健康组,v WF及TSP1水平升高在CMS时改变,而ADAM13水平降低则在缺氧及CMS时均有改变。2.CMS患者PLT数量较高原健康组及西宁健康组均减少,为消耗性减少,一方面对易发血栓倾向有一定的预防和保护作用,另一方面易发生出血。3.高原健康组PLT水平高于西宁健康组,可能高原缺氧环境可致血小板数量代偿性升高。4.CMS组和高原健康组PT与APTT延长呈正相关。
[Abstract]:Objective to investigate the role of vWF- ADAM13 and TSPl in the pathogenesis of CMS by measuring the plasma levels of von Willebrand factorv WFG, von Willebrand factor cleaving protease v WF-CPADAM13 and thrombin sensitive protein 1(thrombospondin 1 TSP1 in patients with CMS. Effective laboratory indicators were used to monitor the state of CMS and to guide clinical treatment. Methods Enzyme-linked immunosorbent assayia Elisa was used to determine 28 cases of CMS patients and 28 cases of high altitude healthy subjects and 28 cases of Xining healthy subjects. Results the plasma vWF levels of ADAM13 and TSP1 in the 1.CMS group were significantly higher than those in the healthy group at high altitude (30.64 卤20.26)U/L) and in the Xining healthy group (22.69 卤9.12 UL / P 0.05 卤2.CMS). The level of plasma ADAM13 in the 1.CMS group was 1.08 卤0.29)ng/ml and 1.01 卤0.19)ng/ml in the high altitude health group, respectively, and the TSP1 level in the 1.CMS group was 1.27 卤0.30 ng / ml P0.03.CMS group (6.94 卤4.78)ng/ml) was higher than that in the healthy group at high altitude. The number of PLT in the high altitude health group (275.03 卤33.42) 脳 10 9 / L was significantly lower than that in the CMS group (151.92 卤64.59) 脳 10 9 / L and Xining healthy group (223.67 卤69.24) 脳 10 9 / L respectively. The number of PLT in the Xining healthy group was 151.92 卤64.59) 脳 10 9 / L higher than that in the high altitude healthy group (275.03 卤33.42) 脳 10 9 / L and Xining healthy group (223.67 卤69.24) 脳 10 9 / L respectively. APTT(44.31 卤9.08 S and 31.90 卤5.45 S were significantly higher in the 1.CMS group than in the Xining healthy group (P 0.05 卤4.17), and there was a positive correlation between PT and APTT prolongation in the high altitude health group and the prolongation of APTT in the plateau health group. Conclusion the plasma vWF level in the 1.CMS group is higher than that in the high altitude healthy group. The levels of ADAM13 in Xining healthy group and Xining healthy group were lower than those in Xining healthy group. The level of TSP1 in Xining healthy group was higher than that in high altitude healthy group and Xining healthy group. The level of v WF and TSP1 in Xining healthy group was higher than that in Xining healthy group. However, the decrease of ADAM13 level changed in anoxia and CMS. 2. The number of PLT in CMS patients was lower than that in high altitude health group and Xining healthy group, which was a consumptive decrease. On the one hand, it had a certain preventive and protective effect on the risk of thrombosis. On the other hand, the level of PLT in high altitude health group is higher than that in Xining healthy group. It is possible that hypoxia environment at high altitude can lead to the compensatory increase of platelet number. 4. PT in high altitude health group and high altitude healthy group is positively correlated with the prolongation of APTT.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R594.3

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