CAJ | 학술논문

目的：探讨检测血浆抗凝血酶(AT)活性(A)、血浆抗凝血酶(AT)抗原(Ag)、蛋白S(PS)、血浆蛋白C(PC)以及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、AT联合PS缺乏组、AT联合PC缺乏组和AT、PS、PC全缺乏组；同时选择60名健康查体人员作为健康对照组。用发色底物法检测两组AT∶A、PC及PS活性；用免疫比浊法检测两组AT∶Ag及血浆D-二聚体浓度水平。采用独立样本的t检验比较各组间差异。结果：AT缺陷症组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(t=-11.68， t=-6.118；P＜0.01)；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(t=-9.397, t=-3.065；P＜0.01)；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，P＜0.01)。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，对预防静脉血栓栓塞症(VTE)的发生起到预警作用。
목적：탐토검측혈장항응혈매(AT)활성(A)、혈장항응혈매(AT)항원(Ag)、단백S(PS)、혈장단백C(PC)이급D-이취체등응혈역전지표대진단유전성항응혈매결함증적림상개치。방법：선택42례항응혈매결함증환자작위질병조，재근거PS、PC수평장질병조진일보분위단순AT결핍조、AT연합PS결핍조、AT연합PC결핍조화AT、PS、PC전결핍조；동시선택60명건강사체인원작위건강대조조。용발색저물법검측량조AT∶A、PC급PS활성；용면역비탁법검측량조AT∶Ag급혈장D-이취체농도수평。채용독립양본적t검험비교각조간차이。결과：AT결함증조AT∶A화AT∶Ag수평명현감저，여건강대조조비교차이유통계학의의(t=-11.68， t=-6.118；P＜0.01)；AT연합PS、PC결핍환자적PS、PC수평명현감저，여건강대조조비교차이유통계학의의(t=-9.397, t=-3.065；P＜0.01)；AT결함증조환자혈장D-이취체수평명현증고，여건강대조조비교차이유통계학의의(t=4.358，P＜0.01)。결론：AT결함시정맥혈전전새성질병적주요유전성위험인소，검측기상관응혈지표유조우질병적조기진단，위림상제공진료의거，대예방정맥혈전전새증(VTE)적발생기도예경작용。
Objective: To discuss detection AT:A and AT:Ag, PS, PC, D-dimer coagulation indexes such as the the clinical value of diagnosis of hereditary antithrombin deficiency. Methods: Choice of 42 patients with antithrombin deficiency as disease group, according to the PS, PC level will be further divided into disease group:simply AT lack of a group, AT joint PS lack of a group, AT joint PC lack of a group and all the lack of a group of AT, PS, PC. Choose 60 cases of healthy physical examination person as healthy controls. Two groups of patients with synthetic chromogenic substrate method test plasma antithrombin activity(AT:A) and plasma protein C(PC), protein S(PS) activity, with immune turbidimetric method test plasma antithrombin antigen (AT:Ag) and the concentration of plasma D-dimer. Using independent-samples T test to compare the differences between the groups. Results: AT defects group of patients AT:A and AT:Ag level is significantly reduced, compared with healthy control group difference was statistically significant(t=-11.68, t=-6.118;P<0.01);the patient's level of PS, PC reduce obviously in lack of AT joint PS, PC group, compared with healthy control group difference was statistically significant(t=-9.397, t=-3.065; P<0.01);AT defects patients plasma D-dimer level significantly increased, compared with healthy control group difference was statistically significant (P<0.01). Conclusion:Antithrombin deficiency is the main genetic risk factor for venous thromboembolism disease, detecting the blood coagulation associated indicators help in the early diagnosis of diseases, basis for clinical diagnosis and treatment, to prevent the occurrence of VTE has played a warning role.