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中国误诊学杂志 2012年第18期12卷 4905-4906页

作者：李烨解放军第二五二医院检验科河北保定071000

纤溶、抗凝和凝血系统是维持机体出血与止血平衡的重要因素，当这些系统中某些因子的数量或功能发生改变的时候，就有可能导致出血或形成血栓。因此测定这些因子的改变有助于诊断易栓症和监测血浆凝血状态。本文主要介绍D-二聚体、抗凝... 详细信息

纤溶、抗凝和凝血系统是维持机体出血与止血平衡的重要因素，当这些系统中某些因子的数量或功能发生改变的时候，就有可能导致出血或形成血栓。因此测定这些因子的改变有助于诊断易栓症和监测血浆凝血状态。本文主要介绍D-二聚体、抗凝血酶Ⅲ、纤维蛋白原联合检测的应用。

关键词：纤维蛋白纤维蛋白原降解物/分析抗凝血酶ⅲ/分析纤维蛋白原/分析

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大鼠实验性急性肝损伤抗凝血酶Ⅲ的测定意义

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南京医科大学学报（自然科学版） 1992年第1期12卷 37-39页

作者：解渝扬州医学院

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抗凝血酶Ⅲ测定的临床意义

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中华内科杂志 1985年第11期24卷 674-677+702页

作者：王宝珍张国祯舒素珍孙丽云王俊敏上海医科大学附属中山医院内科

本文报道心、肺、肾等各种不同疾病中血浆抗凝血酶(AT Ⅲ)免疫活性及凝血活性测定234例,与同年龄组的正常人进行比较,结果肾病、肺功能衰竭中测出的AT Ⅲ水平均有明显降低,这项测定对这些病反映高凝状态有临床参考意义。

关键词：抗凝血酶ⅲ/分析

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因子Ⅷ相关抗原和抗凝血酶Ⅲ测定在流行性出血热患者的临床意义

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青岛医药卫生 1987年第1期 10-14页

作者：翁维权青岛医学院附属医院

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Thromboembolism and resistance to activated protein C in patients with inflammatory bowel disease

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AMERICAN JOURNAL OF GASTROENTEROLOGY 1999年第3期94卷 685-690页

作者： Novacek, G Miehsler, W Kapiotis, S Katzenschlager, R Speiser, W Vogelsang, H Univ Vienna Dept Internal Med 4 Div Gastroenterol & Hepatol A-1090 Vienna Austria Univ Vienna Clin Inst Med & Chem Lab Diagnost A-1090 Vienna Austria Univ Vienna Dept Internal Med 2 Div Angiol A-1090 Vienna Austria

OBJECTIVE: Thromboembolic events are serious complications in patients with inflammatory bowel disease (IBD). Resistance of factor V to degradation by activated protein C (APC) is a major cause for venous thrombosis and is found in approximately 30% of patients with thromboembolism. The aim of the present study was to assess the prevalence of APC resistance and clinical risk factors in patients with IBD. METHODS: One-hundred-two patients with IBD (64 women and 38 men;median age, 35 yr;range, 17-77 yr;77 with Crohn's disease, 25 with ulcerative colitis) and 102 gender- and age-matched healthy control subjects were investigated prospectively for the presence of APC resistance. None of the healthy controls but 16 patients with IBD had a history of thromboembolism. RESULTS: Patients with IBD and thromboembolism were young, with a median age of 37 yr (range, 17-61 yr). Five (31.3%) of them had APC resistance, which was more common than in patients with IBD without thromboembolism (7%) and in controls (5.9%) (p < 0.01). Three patients had two thromboembolic events, the other 13 each had one. Deep vein thrombosis of the leg and pulmonary emboli were the most common thromboembolic complications (84.2%). Active disease, fistula, or bowel stenosis were found in 10 (52.6%) of 19 thromboembolic events;in three (15.8%) cases thromboembolism happened postoperatively. CONCLUSIONS: APC resistance is not associated with IBD but, when present, increases the risk of thromboembolism. Patients with IBD and thromboembolism are mostly young and clinical risk factors can be found in one-half of cases. (Am J Gastroenterol 1999;94:685-690. (C) 1999 by Am. Cell. of Gastroenterology).

关键词：活化蛋白C抵抗/并发症抗凝血酶ⅲ/分析 C反应蛋白质/分析纤维蛋白原/分析炎性肠疾病/血液炎性肠疾病/并发症危险因素血栓栓塞/血液血栓栓塞/病因学青少年成年人老年人女(雌)性人类男(雄)性中年人

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SOME IMMUNOLOGICAL INVESTIGATIONS ON ANTITHROMBIN-III BUDAPEST

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BRITISH JOURNAL OF HAEMATOLOGY 1978年第3期40卷 459-470页

作者： LANE, JL ROYAL CHILDRENS HOSP DEPT CLIN HAEMATOL & ONCOL PARKVILLE 3052 VICTORIA AUSTRALIA

Immunoelectrophoretic studies were carried out on plasma from a patient with an abnormal antithrombin III molecule (antithrombin III ''Budapest''). One-dimensional immunoelectrophoresis using a commercial antibody [Ab] to antithrombin III (Ab to .alpha.2-AtIII) showed 2 precipitin peaks of .alpha.2-AtIII antigen [Ag]. Two-dimensional immunoelectrophoresis showed 2 precipitin peaks, 1 with normal electrophoretic mobility, the other with increased electrophoretic mobility. .alpha.2-AtIII Ag with normal mobility was identical to normal .alpha.2-AtIII and the .alpha.2-AtIII Ag with increased electrophoretic mobility was antigenically deficient and appeared to be present in higher concentration than the normal .alpha.2-AtIII Ag. Although 1-dimensional immunoelectrophoresis on plasma from the patient''s son showed only 1 peak, 2-dimensional immunoelectrophoresis revealed that the son had 2 populations of .alpha.2-AtIII, 1 with normal mobility, the other with increased mobility. The .alpha.2-AtIII Ag with normal mobility appeared to be present in higher concentration than the .alpha.2-AtIII Ag with increased mobility. One- and 2-dimensional immunoelectrophoresis using a different commerical Ab to .alpha.2-AtIII showed only 1 precipitin peak using the patient''s plasma. The precipitin peak observed following 2-dimensional immunoelectrophoresis was asymmetric and showed increased mobility.

关键词：抗原/分析抗凝血酶ⅲ/分析匈牙利免疫扩散免疫电泳沉淀素类/分析血栓性静脉炎/血液血栓性静脉炎/遗传学血栓性静脉炎/免疫学成年人人类男(雄)性

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ANTITHROMBIN AND THROMBOLYTIC EFFECTS OF A NEW ANTITHROMBIN AGENT - ANGIOSCOPIC AND ANGIOGRAPHIC COMPARISON WITH HEPARIN OR BATROXOBIN

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JOURNAL OF INTERVENTIONAL CARDIOLOGY 1994年第5期7卷 409-419页

作者： TOMARU, T NAKAMURA, E MIWA, AY FUJIMORI, Y OMATA, M OKADA, R UCHIDA, Y SecondDepartmentofInternalMedicine FacultyofMedicineUniversityofTokyoJapan.

The antithrombotic effect of three different types of antithrombotic agents (antithrombin:argatroban, heparin, defibrinogenating agent:batroxobin) were evaluated in canine coronary and iliac arteries. An occlusive thrombus formation (heparin 250 U/kg, argatroban 0.5 mg/kg, batroxobin 0.5 U/kg) and the effect of thrombus size reduction was evaluated. On the contralateral side of the iliac artery, the preventive effect of these agents on thrombus formation was evaluated after balloon injury. In the iliac artery, angioscopic percent area obstruction by the thrombus before and 60 minutes after treatment reduced from 69% to 32% in the argatroban group, and from 64% to 51% in the batroxobin group (P < 0.0001 and P < 0.05, respectively). No significant change was observed in the heparin group. Angiography demonstrated the same trend. The percent area stenosis with thrombus at 60 minutes following balloon injury was 0.75% in the argatroban group, 18.9% in the heparin group (P < 0.05 vs argatroban), and 12.9% in the batroxobin group. Thrombus size at the treated site was smaller than that at the control site in all three groups (P < 0.05 vs control). In the coronary artery, angioscopic percent area obstruction by the thrombus before and 60 minutes after treatment reduced from 84% to 53% in the argatroban group, and from 86% to 68% in the batroxobin group (P < 0.001 and P < 0.05, respectively). No significant change was observed in the heparin group. Angiography also demonstrated the same trend. The activated partial thromboplastin time (APTT) was prolonged to 189% of the control value with argatroban and to 1253% of the value with heparin (P < 0.001). Fibrinogen was markedly reduced with batroxobin. These results showed that both the antithrombin agent and the defibrinogenating agent have a preventive effect on thrombus formation and the effect on thrombus size reduction, without marked prolongation of the APTT.

关键词：血管造影术血管镜检查抗凝血酶ⅲ/分析巴曲酶/药理学冠状血管造影术纤维蛋白溶解药/药理学肝素/药理学髂动脉/放射摄影术动物狗

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No benefit of reduced heparinization in thoracic aortic operation with heparin-coated bypass circuits

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ANNALS OF THORACIC SURGERY 2000年第3期69卷 743-749页

作者： Olsson, C Siegbahn, A Haldén, E Nilsson, B Venge, P Thelin, S Univ Uppsala Hosp Dept Cardiothorac Surg S-75185 Uppsala Sweden Univ Uppsala Hosp Dept Clin Chem S-75185 Uppsala Sweden Univ Uppsala Hosp Dept Cardiothorac Anesthesia S-75185 Uppsala Sweden Univ Uppsala Hosp Dept Clin Immunol S-75185 Uppsala Sweden

Background. Heparin coating of the cardiopulmonary bypass circuit attenuates inflammatory response rand confer clinical benefits in cardiac operations. The positive effects may be amplified with reduced systemic heparin dosage. We studied markers of inflammation and coagulation in thoracic aortic operations with heparin-coated circuits and standard vs reduced systemic heparinization. Methods. Thirty patients were randomized to standard (group S;300 IU/kg initially;activated clotting times [ACT] > 480 seconds;5,000 IU in prime;n = 16) or reduced (group R;100 IU/kg initially;ACT > 250 seer ends;2,500 IU in prime;n = 14) dose systemic heparin The following markers were analyzed perioperatively: (a) inflammatory response;acute phase cytokine interleukin-6, and granulocytic proteins myeloperoxidase and lactoferrin;(b) complement activation;factor C3a and the C5a-9 terminal complement complex [TCC];and (c) coagulation;thrombin-antithrombin III complex. Results. The clinical outcome did not differ between groups. Four (29%) patients in group R had a perioperative thromboembolic event. All studied markers were significantly elevated during and throughout cardiopulmonary bypass in both groups. Maximal values were higher in group R for all variables except for TCC. There were no statistically significant intergroup differences regarding markers of inflammation, complement activation, or coagulation activation. Conclusions. The blood trauma in thoracic aortic operation is extensive, as reflected by the elevation of the studied biochemical markers, even when heparin-coated cardiopulmonary bypass circuits are used. In this study, we did not detect any benefits, either biochemical or clinical, of reducing the dose of systemic heparin. (C) 2000 by The Society of Thoracic Surgeons.

关键词：抗凝药/投药和剂量抗凝血酶ⅲ/分析主动脉胸/外科学心肺转流术/仪器和设备补体C3a/分析补体膜攻击复合物/分析肝素/投药和剂量白细胞介素6/血液乳铁蛋白/血液肽水解酶类/分析过氧化物酶/血液手术后并发症/血液手术后并发症/预防和控制老年人女(雌)性人类男(雄)性中年人

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PLATELET ANTI-THROMBIN DEFICIENCY - NEW CLINICAL ENTITY

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AMERICAN JOURNAL OF MEDICINE 1978年第3期65卷 472-478页

作者： TULLIS, JL WATANABE, K NEW ENGLAND DEACONESS HOSP DEPT MED BOSTON MA 02215 USA HARVARD UNIV SCH MED BOSTON MA 02115 USA CTR BLOOD RES BOSTON MA USA

A kindred with a history of multiple thromboses was studied for coagulant abnormalities. A deficiency of serum antithrombin III was found in approximately 1/2 of the 13 family members by coagulant or immunologic assay. No clear relationship between antithrombin III deficiency and a history of thrombosis was present. Platelet antithrombin assays were also studied in the same subjects. Ten of the 13 members were deficient. None of the remaining 3 had a history of thrombosis. The hypothesis is proposed that in some cases familial hypercoagulability may be due to a platelet antithrombin deficiency and that the serum antithrombin III deficiency in some cases is a secondary rather than a primary effect.

关键词：抗凝药/药理学抗凝血酶ⅲ/分析抗凝血酶类/分析血液凝固试验血小板疾病/遗传学血样采集免疫扩散方法血栓形成/血液血栓形成/遗传学青少年成年人老年人女(雌)性人类男(雄)性中年人

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The in vivo kinetics of tissue factor messenger RNA expression during human endotoxemia: relationship with activation of coagulation

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BLOOD 2000年第2期96卷 554-559页

作者： Franco, RF de Jonge, E Dekkers, PEP Timmerman, JJ Spek, CA van Deventer, SJH van Deursen, P van Kerkhoff, L van Gemen, B ten Cate, H van der Poll, T Reitsma, PH Univ Amsterdam Acad Med Ctr Lab Expt Internal Med NL-1105 AZ Amsterdam Netherlands Univ Amsterdam Acad Med Ctr Dept Intens Care NL-1105 AZ Amsterdam Netherlands Organon Teknika BV Boxtel Netherlands

Triggering of the tissue factor (TF)-dependent coagulation pathway is considered to underlie the generation of a procoagulant state during endotoxemia, To determine the in vivo pattern of monocytic TF messenger RNA (mRNA) expression during endotoxemia, 10 healthy volunteers were injected with lipopolysaccharide (LPS, 4 ng/kg) and blood was collected before and 0.5, 1, 2, 3, 4, 6, 8, and 24 hours after LPS administration. Total blood RNA was isolated and amplified by NASBA (nucleic acid sequence-based amplification), followed by quantitation of TF mRNA by an electrochemiluminescence (ECL) assay, To com-pare the pattern of coagulation activation with the kinetics of monocytic TF mRNA expression, we measured plasma levels of markers of thrombin generation, thrombin-antithrombin (TAT) complexes, and prothrombin fragment 1 + 2 (F1 + 2). Baseline value (mean +/- SEM) of the number of TF mRNA molecules per monocytic cell was 0.08 +/- 0.02. A progressive and significant (P < .0001) increase in TF expression was observed after LPS Injection (+0.5 hour: 0.3 +/- 0.1, +1 hour: 1.3 +/- 0.9, +2 hours: 4.1 +/- 0.9), peaking at +3 hours (10 +/- 1.9 TF mRNA molecules per monocyte), As TF mRNA levels Increased, thrombin generation was augmented, Peak levels of TAT and F1 + 2 were reached later (at t +4 hours) than those of TF mRNA. TF mRNA, TAT, and F1 + 2 levels returned to baseline after 24 hours. In conclusion, we used a NASBA/ECL-based technique to quantify TF mRNA in whole blood during human endotoxemia and observed a 125-fold increase in TF mRNA levels, Our data demonstrate a pivotal role for enhanced TF gene activity in the activation of coagulation after LPS challenge. (C) 2000 by The American Society of Hematology.

关键词：抗凝血酶ⅲ/分析血液凝固内毒素血症/血液基因表达动力学脂多糖类/药理学肽碎片/分析肽水解酶类/分析凝血酶原/分析 RNA 信使/代谢凝血致活酶/遗传学凝血致活酶/代谢成年人人类男(雄)性

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