摘要
目的探讨严重急性呼吸综合征(SARS)后骨坏死的病因学,以便用于非创伤性骨坏死的早期诊断和易感人群的筛选。方法取61例SARS后骨坏死患者空腹肘静脉血。另取健康人群52名为对照,应用酶联免疫吸附法等试验定凝血、纤溶指标,应用实时聚合酶链反应(PCR)仪测定因子V G1691A(FV Le iden)变、凝血酶原G20210A突变。结果SARS后骨坏死患者血液学因素改变明显,其中蛋白C(PC)、活化蛋白C抵抗(APC-R)、抗凝血酶Ⅲ(AT-Ⅲ)、纤溶酶原激活抑制物(PAI)、纤溶酶原(PLG)。两组比较,差异有统计学意义(109%±20%vs 85%±34%、8.0 U/m l±4.3U/m l、16 U/m l±14 U/m l、197 s±46 s vs 192 s±63 s、104%±14%vs 84%±29%、94%±15%vs69μ/m l±23μ/m l,P<0.01)。骨坏死组和对照组均未发现因子V Le iden突变和凝血酶原G20210A的突变。结论SARS后骨坏死患者存在高凝低纤溶倾向,对骨坏死易感人群可以进行高凝和低纤溶指标的筛选,PC、AT-Ⅲ、PAI、APC-R、PLG可作为骨坏死易感因素的筛选指标。SARS后骨坏死与因子V Le iden和凝血酶原G20210A突变无关。
Objective To investigate the hematological changes and related gene mutation of postsevere acute respiratory syndrome （SARS） patients with osteonecrosis so as to find the sensitive molecular symbols for early screening of the high risk populations. Methods Fast peripheral venous blood samples were collected from 61 post-SARS patients with osteonecrosis, 25 males and 36 females, aged 30.4 （ 20- 60）, and 52 sex and age-matched healthy persons as controls. ELISA was used to detect the coagulation and fibfinolysis indicators： activated partial thromboplastin time （APTT）, protein C （PC）, antithrombin m （AT-Ⅲ）, plasminogen activator inhibitor （PAI） , activated protein C resistance （APC-R）, plasminogen （PLG） , von Willebrand factor （VWF） , D-dimer （D-D） , and fibfinogen （Fib）. Real-time PCR was used to detect the mutation of factor V G1601A （FV Leiden） and prothrombin G20210A. Results The levels of PC , AT-Ⅲ, and PLG of the osteonecrosis group were 85% ± 34%, 84 ± 29%, and 69 ± 23%, significantly lower than that of the control group （ 109% ± 20%, 104% ± 14%, and 94% ± 15% respectively, all P 〈 0. 01 ）. PAI of the eeteonecrosis group was 16 U/ml ± 14 U/ml, significantly higher than that of the control group （ 8.0 U/ml ± 4.3 U/ml, P 〈 0.01 ）. The percentage of patients with abnormal indicators was 99.5% （54/61） in the eeteonecrosis group, significantly higher than that of the control group （36.5%, 19/52, P 〈0.01 ）. The percentage of patients with 3 or more abnormal indicators was 72.1% （44/61） in the eeteonecrosis group, significanfly higher than that of the control group （ 17.3%, 9/52, P 〈 0. 01 ）. No mutations of F V Leiden and prothrombin G20210A was found in both groups. Conclusion Trends of hypercoagulation and hypofibrinolysis exist in the post-SARS patients with osteonecrosis. APTT, PC, AT-Ⅲ, and PLG can be used as sensitive indicator for screening high risk populations of osteonecrosis.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第7期442-445,共4页
National Medical Journal of China
基金
卫生部部属(管)临床学科重点项目(2002-1007)
首都医学发展基金重大联合项目(2002-1007)
关键词
骨坏死
肺炎
血液凝固
Osteonecrosis
Pneumonia
Blood coagulation
