發(fā)布時間：2018-03-23 10:09

  本文選題：慢性高原病　切入點：血管性血友病因子　出處：《青海大學》2015年碩士論文

【摘要】：目的 通過測定CMS患者血漿中血管性血友病因子(von Willebrand factor,v WF)、血管性血友病因子裂解蛋白酶(von Willebrand factor cleaving protease,v WF-CP,ADAM13)及凝血酶敏感蛋白1(thrombospondin 1,TSP1)水平,探討v WF、ADAM13及TSPl在CMS發(fā)生中的作用,尋找敏感、有效的實驗室指標對CMS的病情變化進行監(jiān)測并指導臨床治療。方法 采用酶聯(lián)免疫吸附法(enzyme-linked immunosorbent assay,ELISA)測定28例CMS患者、28例高原健康受試者(GY)和28例西寧健康受試者(XN)血漿v WF、ADAM13及TSP1水平。結果 1.CMS組血漿v WF水平(64.41±12.87)U/L高于高原健康組(30.64±20.26)U/L及西寧健康組(22.69±9.12)U/L(P0.05);2.CMS組血漿ADAM13水平(1.08±0.29)ng/ml與高原健康組(1.01±0.19)ng/ml均低于西寧健康組(1.27±0.30)ng/ml(P0.05);3.CMS組TSP1水平(6.94±4.78)ng/ml高于高原健康組(3.97±2.20)ng/ml及西寧健康組(2.55±2.94)ng/ml(P0.05);4.高原健康組PLT數量(275.03±33.42)×109/L較CMS組(151.92±64.59)×109/L及西寧健康組(223.67±69.24)×109/L升高(P0.05);5.CMS組PLT數量(151.92±64.59)×109/L較高原健康組(275.03±33.42)×109/L及西寧健康組(223.67±69.24)×109/L均減少(P0.05);6.CMS組PT(16.03±4.23)S較高原健康組(12.22±0.86)S及西寧健康組(12.21±1.0)S延長(P0.05);7.CMS組APTT(44.31±9.08)S及高原健康組(31.90±5.45)S均較西寧健康組(28.17±4.17)S延長(P0.05);8.CMS組PT與APTT延長呈正相關(r=0.504);高原健康組PT與APTT延長也呈正相關(r=0.430)。結論 1.CMS患者組血漿v WF水平高于高原健康組及西寧健康組,ADAM13水平均低于西寧健康組,CMS組TSP1水平高于高原健康組及西寧健康組,v WF及TSP1水平升高在CMS時改變,而ADAM13水平降低則在缺氧及CMS時均有改變。2.CMS患者PLT數量較高原健康組及西寧健康組均減少,為消耗性減少,一方面對易發(fā)血栓傾向有一定的預防和保護作用,另一方面易發(fā)生出血。3.高原健康組PLT水平高于西寧健康組,可能高原缺氧環(huán)境可致血小板數量代償性升高。4.CMS組和高原健康組PT與APTT延長呈正相關。
[Abstract]:Objective to investigate the role of vWF- ADAM13 and TSPl in the pathogenesis of CMS by measuring the plasma levels of von Willebrand factorv WFG, von Willebrand factor cleaving protease v WF-CPADAM13 and thrombin sensitive protein 1(thrombospondin 1 TSP1 in patients with CMS. Effective laboratory indicators were used to monitor the state of CMS and to guide clinical treatment. Methods Enzyme-linked immunosorbent assayia Elisa was used to determine 28 cases of CMS patients and 28 cases of high altitude healthy subjects and 28 cases of Xining healthy subjects. Results the plasma vWF levels of ADAM13 and TSP1 in the 1.CMS group were significantly higher than those in the healthy group at high altitude (30.64 鹵20.26)U/L) and in the Xining healthy group (22.69 鹵9.12 UL / P 0.05 鹵2.CMS). The level of plasma ADAM13 in the 1.CMS group was 1.08 鹵0.29)ng/ml and 1.01 鹵0.19)ng/ml in the high altitude health group, respectively, and the TSP1 level in the 1.CMS group was 1.27 鹵0.30 ng / ml P0.03.CMS group (6.94 鹵4.78)ng/ml) was higher than that in the healthy group at high altitude. The number of PLT in the high altitude health group (275.03 鹵33.42) 脳 10 9 / L was significantly lower than that in the CMS group (151.92 鹵64.59) 脳 10 9 / L and Xining healthy group (223.67 鹵69.24) 脳 10 9 / L respectively. The number of PLT in the Xining healthy group was 151.92 鹵64.59) 脳 10 9 / L higher than that in the high altitude healthy group (275.03 鹵33.42) 脳 10 9 / L and Xining healthy group (223.67 鹵69.24) 脳 10 9 / L respectively. APTT(44.31 鹵9.08 S and 31.90 鹵5.45 S were significantly higher in the 1.CMS group than in the Xining healthy group (P 0.05 鹵4.17), and there was a positive correlation between PT and APTT prolongation in the high altitude health group and the prolongation of APTT in the plateau health group. Conclusion the plasma vWF level in the 1.CMS group is higher than that in the high altitude healthy group. The levels of ADAM13 in Xining healthy group and Xining healthy group were lower than those in Xining healthy group. The level of TSP1 in Xining healthy group was higher than that in high altitude healthy group and Xining healthy group. The level of v WF and TSP1 in Xining healthy group was higher than that in Xining healthy group. However, the decrease of ADAM13 level changed in anoxia and CMS. 2. The number of PLT in CMS patients was lower than that in high altitude health group and Xining healthy group, which was a consumptive decrease. On the one hand, it had a certain preventive and protective effect on the risk of thrombosis. On the other hand, the level of PLT in high altitude health group is higher than that in Xining healthy group. It is possible that hypoxia environment at high altitude can lead to the compensatory increase of platelet number. 4. PT in high altitude health group and high altitude healthy group is positively correlated with the prolongation of APTT.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R594.3

【參考文獻】

相關期刊論文 前10條

1 青格樂圖;;高原紅細胞增多癥86例的血常規(guī)結果分析[J];國際檢驗醫(yī)學雜志;2011年16期

2 陳宇,張鈞華,唐朝樞;內皮功能障礙與冠脈疾病[J];海軍總醫(yī)院學報;2004年02期

3 雷應權,任雨笙,符中明,馮國軍,劉煒;高原紅細胞增多癥患者D-二聚體測定的意義[J];臨床軍醫(yī)雜志;2003年04期

4 芮魏;張芳;鄧曉蓓;陳德亮;李潤奎;丁文軍;;可吸入顆粒物與血管內皮細胞功能紊亂的關系[J];環(huán)境與健康雜志;2013年05期

5 吳慶強;孫子林;梁軍;竇連軍;;2型糖尿病患者血小板凝血酶敏感蛋白的臨床意義[J];四川醫(yī)學;2008年10期

6 盧國元;劉芳;郭小芳;王兆鉞;蘇健;白霞;阮長耿;;血管性血友病因子裂解酶及凝血酶敏感蛋白1在狼瘡性腎炎中的意義[J];蘇州大學學報(醫(yī)學版);2006年02期

7 薛文成,崔莎,齊寶宏;高原紅細胞增多癥患者血小板參數變化[J];實用醫(yī)技雜志;2004年13期

8 張丹丹;肖娟;黃浩梁;陳娟娟;劉濤;尹宗智;高單萍;劉瓊;艾繼輝;陳素華;;Von Willebrand Factor Antigen and ADAMTS13 Activity Assay in Pregnant Women and Severe Preeclamptic Patients[J];Journal of Huazhong University of Science and Technology(Medical Sciences);2010年06期

9 劉蓮;蔣紅梅;費櫻;胡昌維;;類風濕性關節(jié)炎患者血清超氧化物歧化酶和血管性血友病因子水平變化及意義[J];中國全科醫(yī)學;2014年23期

10 張江麗;劉恩甫;耿東明;劉占卿;趙金濤;;血清甲狀腺激素及血友病因子水平與COPD并發(fā)Ⅱ型呼吸衰竭的相關性分析[J];臨床合理用藥雜志;2014年28期

相關碩士學位論文 前2條

1 加娜提;高同型半胱氨酸血癥對大鼠血管內皮功能的影響[D];新疆醫(yī)科大學;2007年

2 衛(wèi)華;高原高寒環(huán)境因素對內皮細胞的損傷作用及其保護作用化合物研究[D];中國人民解放軍軍事醫(yī)學科學院;2012年

，

本文編號：1652997