本文選題：出凝血分子標志物 + 彌散性血管內凝血��； 參考：《山東大學》2017年碩士論文

【摘要】：目的探討凝血酶-抗凝血酶復合物(thrombin-anti-thrombin complex,TAT)、纖溶酶-α 2 纖溶酶抑制劑復合物(plasmin-α 2-plasmin inhibitor complex,PIC)、血栓調節(jié)蛋白(tlrombomodulin,TM)、組織型纖溶酶原激活劑-纖溶酶原激活物抑制劑復合物(tissue-type plasminogen activator-plasminogen activator inhibitor complex,t-PAl-C)四種出凝血分子標志物在彌散性血管內凝血(Disseminated Intravascular Coagulation,DIC)的動態(tài)變化,評估其對于DIC早期診斷的意義。方法所有33例研究對象選自2016年9月至2017年3月山東大學齊魯醫(yī)院收治的凝血機能障礙患者。33例患者入院時9例確診為DIC,24例疑診DIC,疑診組中5例發(fā)展為DIC。根據(jù)最終診斷將33例研究對象分為DIC組(14例)和非DIC組(19例)。在患者入院后第1、3、7天,用高敏化學發(fā)光法檢測患者血漿TAT、PIC、TM、t-PAI-C的濃度。另取正常對照組30人,排除血液系統(tǒng)疾病、感染、外傷、血栓性疾病、肝腎疾病等,測定其血漿TAT、PIC、TM、t-PAI-C的濃度。結果第 1、3 天 DIC 組血漿 TAT 水平(16.83±13.21,21.66±24.58)ng/mL 明顯高于非 D1C 患者(4.9±2.62,3.47±1.69)ng/mL,P 值分別為(0.005,0.016)。第1天DIC組血漿PIC水平(4.63±6.23)μ g/mL明顯高于非DIC組患者(0.93±0.59)μg/mL,P值為 0.045。第1、3、7天DIC組血漿TM水平(31.31±18.75,36.61±20.31,30.21±18.32)TU/mL 均高于非 DIC 組(11.19±2.99,11.1±4.32,11.37±3.88)TU/mL,P 值分別為(0.001,0.001,0.002)。第7天DIC組血漿t-PAI-C水平(24.23±29.9)ng/mL高于非DIC組患者(6.72±4.56)ng/mL,P 值為 0.048。DIC 患者的血漿 TAT(18.10±21.23)ng/mL,PIC(3.80±5.02)u g/mL,TM(32.71±18.88)TU/mL,t-PAI-C(23.93±32.30)ng/mL,明顯高于非 DIC 患者 TAT(4.37±4.40)ng/mL,PIC(1.03±0.69)μg/mL,TM(11.22±3.71)TU/mL,t-PAI-C(6.87±4.35)ng/mL,P 值分別為0.001,0.001,0.001,0.001,均有統(tǒng)計學差異。第1天血漿TAT、TM的ROC曲線下面積分別為0.83、0.91,P值均0.01。結論DIC早期即發(fā)生血漿凝血酶-抗凝血酶復合物(thrombin-anti-thrombin complex,TAT)、纖溶酶-α 2 纖溶酶抑制劑復合物(plasmin-α 2-plasmin inhibitor complex,PIC)、血栓調節(jié)蛋白(thrombomodulin,TM)濃度的顯著升高,動態(tài)檢測血漿TAT、PIC、TM的水平有助于DIC的早期診斷。
[Abstract]:Objective to investigate the thrombin antithrombin complex thrombin-anti-thrombin complex, plasmin- 偽 2 plasmin- 偽 2-plasmin inhibitor complex, thrombombomodulinTMN, tissue type plasminogen activator / plasminogen activator inhibitor complex tissue-type plasminogen activator-plasminogen activator.The dynamic changes of inhibitor complext-PAl-C4 molecular markers in disseminated intravascular coagulation (DICs).To evaluate its significance for early diagnosis of DIC.Methods all 33 patients were selected from Qilu Hospital of Shandong University from September 2016 to March 2017. Nine of 33 patients with coagulation dysfunction were diagnosed as DICs on admission, and 5 of them in suspected group were diagnosed as DICs.According to the final diagnosis, 33 cases were divided into DIC group (n = 14) and non DIC group (n = 19).On the 1st day after admission, Gao Min chemiluminescence assay was used to detect the plasma TATICPICT T PAI-C concentration.The plasma levels of TATICPICT-PAI-C were determined in 30 normal control subjects, excluding blood system diseases, infections, trauma, thrombotic diseases, liver and kidney diseases, and so on.Results the plasma TAT level in the DIC group was significantly higher than that in the non-D1C group on the 1st day (16.83 鹵13.21 鹵21.66 鹵24.58)ng/mL, 4.9 鹵2.62 鹵3.47 鹵1.69 ng / mL, P = 0.005 鹵13.21 鹵21.66 鹵0.016), respectively.On the first day, the plasma PIC level in DIC group was 4.63 鹵6.23 渭 g/mL significantly higher than that in non- group (0.93 鹵0.59) 渭 g / mL (P = 0.045).The plasma TM level in the DIC group was 31.31 鹵18.75 鹵20.31 鹵20.31 鹵20.31 鹵30.21 鹵18.32)TU/mL on the 7th day, which was higher than that in the non- group (11.19 鹵2.99 鹵11.1 鹵4.32 鹵11.37 鹵3.88 Tu / mLN P = 0.001 鹵0.001).絎，

本文編號：1757746