摘要
目的 探讨血浆抗凝血因子PC ,PS ,TM在尿毒症止血、凝血异常导致出血并发症中的作用。方法 采用双抗夹心ELISA法 ,发色底物法测定 4 5例尿毒症血透患者血浆PC (PCAg,APC) ,PS(TPS ,FPS) ,TM含量。结果 尿毒症患者PCAg ,TPS ,FPS ,TM含量明显高于正常对照组 (P <0 0 5 ,P <0 0 0 1) ,而PC活性 (APC)明显低于对照组 (P <0 0 0 1)。维持性血透患者血浆APC ,TPS ,FPS血透后明显升高 (P <0 0 5 ,P <0 0 0 1) ;TM血透后明显降低 (P <0 0 0 1)。有出血倾向的尿毒症患者血浆APC均明显升高 (P <0 0 5 )。结论 尿毒症患者蛋白C抗凝活性降低 (APC) ,与尿毒症时高凝倾向和血栓形成有关。血液透析治疗的尿毒症患者在原有高凝状态基础上 ,透析后仍可激活凝血系统 。
Objective The aim of this study was to find out the Protein C(PC) system anticoagulant activity patients with uremia bleeding tendency.Methods Enzyme-Linked Immunosorbent Assay(ELISA) method was used to measure the plasma levels of the protein C,Protein S antigen(total and free),Thrombomodulin(TM) and D-dimer.Results Patients with endstage renal insufficiency had a higher PC antigen,Protein S antigen,Thrombomodulin level compared with the controls(P<0 05,P<0 001 respectively),while the protein C activity was dramatically lower than the control.In uremic patients on maintenance hemodialysis treatment,significant correlations between the functional activity of PC and TPS,FPS,TM level compared with the predialysis(P<0 05,P<0 001,P<0 001 respectively).A progressive increase of the functional activity of Protein C was observed in uremic patients with bleeding after hemodialysis treatment (P<0 05).Conclusion The finding of a reduced functional PC in uremia indicates that the activity of coagulationfibrinolytic is abnormal in uremic patients,and that bleeding and thrombsis may complicate the course of chronic uremia.Impairment in PC activation seems to be reversible since hemodialysis increases the functional PC. [
出处
《中华急诊医学杂志》
CAS
CSCD
2003年第2期82-83,共2页
Chinese Journal of Emergency Medicine
基金
沈阳市科委科研基金资助 (No .96 9)
