中国易栓人群抗凝蛋白缺陷与血栓形成易感性的研究

发布时间：2017-12-31 16:18

本文关键词：中国易栓人群抗凝蛋白缺陷与血栓形成易感性的研究　出处：《中国人民解放军医学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的：研究中国人群静脉血栓栓塞症及脑梗患者PC、PS、AT活性水平,分析这三种抗凝蛋白与静脉血栓形成的相关性及分析中国人群静脉血栓患者的易栓因素。方法：选择2014年1月至2015年1月来解放军总医院就诊的静脉血栓栓塞症及脑梗患者共168例,分析其年龄分布,血栓形成部位,并分别检测其PC、PS、AT活性水平;同时选择50名健康查体人员作为对照组,检测其PC、PS、AT活性水平,与病例组作对照。结果：四十到五十岁是静脉血栓和脑梗的集中高发年龄,占23.2%。下肢静脉是静脉血栓栓塞症患者最易受累部位,下肢静脉血栓在每个年龄所占比例均超过50%。静脉血栓栓塞症患者组与正常对照组比较,三种抗凝蛋白差异均有统计学意义,p值均0.01。脑梗患者组与正常对照组比较,PS、PC两项活性水平差异有统计学意义,p值均0.05,AT活性水平差异无统计学意义,p值0.05。静脉血栓栓塞症患者组与脑梗患者组比较,三种抗凝蛋白差异均无统计学意义,p值均0.05。结论：AT、PS、PC三种抗凝蛋白均是静脉血栓栓塞症的易感因素；PS、PC两种抗凝蛋白也是脑梗的易感因素。在临床中,抗凝蛋白检测越来越受到广大临床医生的认可,其活性水平可以为血栓性疾病的预防和诊断提供及时可靠的有力依据。目的：探讨检测AT:A、AT:Ag、PS、PC、D-二聚体等凝血易栓指标对诊断遗传性抗凝血酶缺陷症的临床价值。方法：选择42例抗凝血酶缺陷症患者作为疾病组,再根据PS、PC水平将疾病组进一步分为单纯AT缺乏组(27例)、AT联合PS缺乏组(6例)、AT联合PC缺乏组(3例)和AT、PS、PC全缺乏组(6例)；选择60例健康查体人员作为健康对照组。用发色底物法检测两组患者血浆AT：A及PC、PS活性,用免疫比浊法检测两组患者血浆AT:Ag及血浆D-二聚体浓度。采用独立样本的t检验比较各组间差异。结果：AT缺陷症组患者AT：A和AT:Ag水平明显减低,与健康对照组比较差异有统计学意义(AT:At=-11.68, P0.01; AT:Agt=-6.118, P0.01); AT联合PS、PC缺乏患者的PS、PC水平明显减低,与健康对照组比较差异有统计学意义(PS t=-9.397,p0.01; PC t=-3.065,P0.01);AT缺陷症组患者血浆D-二聚体水平明显增高,与健康对照组比较差异有统计学意义(t=4.358,P0.01)。结论：AT缺陷是静脉血栓栓塞性疾病的主要遗传性危险因素,检测其相关凝血指标有助于疾病的早期诊断,为临床提供诊疗依据,对预防VTE的发生起到了预警作用。
[Abstract]:Objective: To study the Chinese population of venous thromboembolism in patients with cerebral infarction and PC, PS, AT activity level, the analysis of the three kinds of anticoagulant proteins and venous thrombosis and correlation analysis of thrombophilia factors of venous thrombosis in patients with Chinese population. Methods: from January 2014 to January 2015 to the Liberation Army General hospital for treatment of venous thromboembolism and cerebral infarction patients a total of 168 cases, analysis of the age distribution, thrombosis parts, and to detect their PC, PS, AT activity level; and 50 healthy people as control group, to detect the PC, PS, AT activity, compared with the case group. Results: Forty to 50 is high age vein thrombosis and cerebral infarction, accounting for 23.2%. of lower limb vein in patients with venous thromboembolism is the most easily affected parts, lower extremity venous thrombosis in each age accounted for the proportion of more than 50%. in patients with venous thromboembolism group and normal control group Comparison of three kinds of anticoagulant protein differences were statistically significant, P value compared with the normal control group were 0.01. patients with cerebral infarction PS group, the difference was statistically significant PC two activity level, P value was 0.05, there were no significant differences in AT activity level of 0.05. in patients with venous thromboembolism group and cerebral infarction patients group P value. Three kinds of anticoagulant proteins had no significant difference, P values were 0.05. AT, PS PC, conclusion: the three kinds of anticoagulant proteins are venous thromboembolism risk factors; PS, the predisposing factors of PC two kinds of anticoagulant proteins in clinical cerebral infarction. Also, anticoagulant protein detection has been more and more recognized by the majority of clinicians the level of activity, can provide a strong basis for reliable and timely diagnosis and prevention of thrombotic diseases. Objective: To investigate the detection of AT:A, AT:Ag, PS, PC, D- two dimers coagulation thrombophilic index clinical value for diagnosis of hereditary antithrombin deficiency syndrome. Methods: 42 cases of antithrombin deficiency patients as the disease group, according to PS, the PC level will be further divided into simple disease group AT deficiency group (27 cases), AT combined with PS deficiency group (6 cases), AT combined with PC deficiency group (3 cases) and AT, PS, PC deficiency group (6); 60 cases of patients with healthy people as healthy control group. Using chromogenic assay in two groups AT:A and PC, PS activity, with immunoturbidimetry in two groups of patients with plasma AT:Ag and plasma D- two concentration. Independent samples t test was used to compare the difference between groups. Results: AT deficiency in patients with AT:A and AT:Ag was significantly reduced, and health was significantly lower than the control group (AT:At=-11.68, P0.01; AT:Agt=-6.118, P0.01; AT) combined with PS, PC deficiency in patients with PS, PC was significantly reduced, and health was significantly lower than the control group (PS t=-9.397, PC t=-3.065, P0.01; P0.01) ; AT deficiency patients plasma D- two level of D-dimer increased significantly, and health was significantly lower than the control group (t=4.358, P0.01). Conclusion: AT defect is the major genetic risk factors of venous thromboembolic disease, early diagnosis and its related coagulation parameters contribute to disease, provide the basis for clinical diagnosis and treatment. The role of early warning to prevent the occurrence of VTE.

【学位授予单位】：中国人民解放军医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R543.6

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