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目的 观察下肢深静脉血栓形成 (DVT)患者凝血指标的变化 ,并探讨其临床意义。方法 采用FLISA法检测 10 8例下肢DVT患者 [完全阻塞性DVT组 (4 9例急性首发及 17例复发DVT)、非完全阻塞性DVT组 (4 2例高危无症状DVT) ]及 4 1例正常对照者血浆组织型纤溶酶原活化物活性 (tPA)、纤维酶原活化物抑制物活性 (PAI)、D二聚体 (DD)、血管性假血友病因子抗原 (vWF∶Ag)、凝血酶原断片 (F1 + 2 )和血小板α颗粒膜蛋白 (GMP14 0 )水平。结果 下肢DVT组血浆F1 + 2 、DD与vWF∶Ag水平较正常对照明显增高 ;完全阻塞性DVT组血浆PAI、DD、GMP14 0水平和PAI/tPA比值较非完全阻塞组显著增高。F1 + 2 、DD与vWF∶Ag呈显著正相关。结论 血浆F1 + 2 、DD与vWF∶Ag水平在一定程度上能反映下肢DVT患者的血管内皮细胞损伤和血液高凝状态 ;GMP14 0、DD、PAI水平和PAI/tPA比值有可能作为鉴别完全和非完全阻塞性DVT的指标
Objective To observe the changes of coagulation index in patients with deep venous thrombosis (DVT) and to discuss its clinical significance. Methods A total of 108 DVT patients with lower extremity [complete obstructive DVT (49 acute and 17 recurrent DVT), non-complete obstructive DVT (42 asymptomatic DVT) and 41 Plasma Tissue Plasminogen Activator Activity (tPA), Plasminogen Activator Inhibitor Activity (PAI), D-dimer (DD), vWF antigen (vWF: Ag) , Prothrombin fragment (F1 + 2) and platelet α-granule membrane protein (GMP14 0). Results The levels of plasma F1 + 2, DD and vWF: Ag in lower extremity DVT group were significantly higher than those in normal control group. The levels of PAI, DD, GMP14 0 and PAI / tPA in patients with complete obstruction of DVT were significantly higher than those in non-obstructive group. F1 + 2, DD and vWF: Ag were significantly positive correlation. Conclusions The levels of F1 + 2, DD and vWF: Ag in plasma may reflect the vascular endothelial cell injury and blood hypercoagulability in lower extremity DVT to a certain extent. The levels of GMP14 0, DD, PAI and the ratio of PAI / tPA are likely to be the best Indicators of incomplete obstruction of DVT