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目的 揭示高半胱氨酸（ Ｈｃｙ） 致血栓形成的机制。方法 ①免疫荧光分析血管内皮细胞凝血酶调节蛋白（ Ｔ Ｍ） 抗原分布；②发色基质法测定肝素辅助因子Ⅱ（ Ｈ ＣⅡ） 活性。结果 ① Ｈｃｙ 可下调血管内皮细胞表面 Ｔ Ｍ 的表达，且呈浓度依赖性；② Ｈｃｙ 对 Ａ Ｄ Ｐ 和凝血酶诱导的血小板聚集均无影响；③在正常人血浆体系中， 以肝素和硫酸皮肤素（ Ｄ Ｓ） 为激动剂， Ｈｃｙ 对血浆 Ａ ＴⅢ和 Ｈ ＣⅡ的抗凝血酶活性无明显影响， 在纯化的 Ａ ＴⅢ体系， Ｈｃｙ 对 Ａ ＴⅢ的抗凝血酶作用也无影响。结论 Ｈｃｙ 的致血栓效应与其对内皮细胞 Ｔ Ｍ 表达调节有关，且独立于血小板聚集功能和肝素辅助因子活性变化。
Objective To reveal the mechanism of homocysteine (Hcy) induced thrombosis. Methods Immunofluorescence assay was used to analyze the distribution of thrombomodulin (T M) in vascular endothelial cells. The activity of heparin c Ⅱ (H C Ⅱ) was detected by chromogenic substrate method. Results ① Hcy down-regulated the expression of T M on the surface of vascular endothelial cells in a concentration-dependent manner; ② Hcy had no effect on both A D P and thrombin-induced platelet aggregation; ③ In normal human plasma system, (D S) as an agonist, Hcy on plasma A T and H C Ⅱ antithrombin activity had no significant effect in purified A T system, Hcy on A T antithrombin effect No effect. Conclusion The thrombotic effect of Hcy is related to the regulation of T M expression in endothelial cells, and is independent of the platelet aggregation function and heparin cofactor activity.