弥散性血管内凝血患儿凝血障碍的检测及其临床意义

目的探讨弥散性血管内凝血（DIC）患儿凝血障碍的检测及临床意义。方法用免疫法、发色底物法和凝固法分别测定39例DIC患儿血浆D二聚体（D-D）、抗凝血酶活性（AT：A）、凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、凝血酶时间（TT）、纤维蛋白原含量（Fbg）等凝血及抗凝指标。结果DIC患儿的凝血指标与正常对照组儿童间差异有统计学意义，特别是D-D含量明显增高，AT：A明显减低，差异具有显著性意义（P〈0．01）；DIC发生时死亡组AT：A阳性率达100％。结论各凝血指标特别是AT：A快速定量检测对DIC的诊断和预后评估有较高价值。     

妊娠期糖尿病患者血浆抗凝血酶Ⅲ、D-二聚体检测的临床意义

目的探讨妊娠期糖尿病患者血浆抗凝血酶（AT-Ⅲ）、D-二聚体（D-D）检测的临床意义。方法以妊娠期糖尿病（GDM）患者26例为观察组,正常孕产妇26例为对照组,分别检测两组孕产妇血浆中AT-Ⅲ、D-D的浓度并进行对比分析。结果 GDM患者血浆中的AT-Ⅲ明显低于对照组,差异有高度统计学意义（P〈0.01）;GDM患者D-D浓度高于对照组,差异有高度统计学意义（P〈0.01）。GDM组AT-Ⅲ、D-D之间存在线性负相关（r=-0.848,P〈0.01）。结论妊娠期糖尿病患者存在高凝状态,检测妊娠期糖尿病患者血浆AT-Ⅲ、D-D,可作为妊娠期糖尿病病情发展变化的一项重要指标。     

抗凝蛋白活性检测质控物的研制及初步评价

目的 利用新鲜冰冻血浆制备抗凝血酶、蛋白C、蛋白S活性检测质控物,评价其均匀性和稳定性,并试用于室内质控.方法 依据ISO Guide35及CNAS-GL03的要求,对2个批次自制质控物的均匀性和稳定性进行评价.将质控物试应用于室内质控,同时检测商品质控物作为对照.结果 均匀性评价结果显示质控物样品间均匀性良好,差异无统计学意义(P＞0.05),AT、PC和PS的瓶间均匀性不确定度ubb的分布范围分别为0.30％～2.39％,0.16％～2.45％和0.19％～3.62％;复融后在室温和冷藏条件下3种抗凝蛋白活性稳定时间分别为24 h和24 h、8h和12h、3h和12h.第1批次质控物长期稳定性评价结果显示正常和异常浓度水平的AT和PC质控物的稳定时间为24周,正常浓度的PS质控物稳定时间为19周,异常低浓度的PS质控物稳定时间为12周;3个项目的长期稳定性不确定度ults范围分别为2.45％～3.68％、1.32％～3.19％和3.97％～10.17％.室内质控试应用结果显示3个项目第1批次各批号质控物检测结果的CV均小于厂商规定的批间不精密度,与商品质控物具有可比性.结论 质控物的均匀性、稳定性符合相关指南要求,可应用于室内质控.     

Design of antithrombotic agents: An introduction

Summary A brief overview of the control of hemostasis is presented that relates physiologically important functions and interactions of the proteins discussed in this volume, i.e.: factor Xa, thrombin, antithrombin III, protein C, protein S, thrombomodulin, ADP receptor, thrombin receptor and fibrinogen receptor.     

川芎嗪抗凝血酶诱导的单个核细胞——血小板聚集

凝血酶可诱导单个核细胞与血小板之间发生聚集,此聚集为一Ca~(2+)依赖过程。川芎嗪对此有明显的抑制作用,呈剂量—效应关系。川芎嗪也可预防静注凝血酶引起的小鼠周围血白细胞计数下降,提示在体内也可能抑制白细胞聚集。当归、丹参酮Ⅱ_A等血小板抑制剂对凝血酶诱导的单个核细胞—血小板聚集无明显影响。     

Analysis of antithrombin III microheterogeneity by isoelectric focusing in polyacrylamide gels and immunoblotting

Microheterogeneity of antithrombin III (ATIII) was examined in pooled normal human plasma and serum by IEF/PA and immunoblotting techniques. A pattern consisting of 8 bands varying in isoelectric point from 4.7 to 5.2 was observed in citrated plasma following IEF in a pH range of 4-6. A similar pattern was observed in all 149 healthy adults examined. The reactivity of ATIII with heparin or, thrombin was investigated using this technique. Characteristic shifts of the banding pattern to the anode or, cathode respectively were observed.     

A pilot study of the effect of gemfibrozil on some haematological parameters

In a double-blind 13 week study the effects of Gemfibrozil were compared with placebo. Gemfibrozil was given to 10 patients with evidence of severe atherosclerosis; four similar patients acted as controls. As expected, in the treated group, total cholesterol and triglycerides decreased significantly and HDL cholesterol increased. The Fibrinogen did not change although the ESR increased markedly and the heparin neutralizing activity (HNA) of the plasma decreased (p = 0.01). The antithrombic activity increased. The change in the HNA correlated weakly to the total cholesterol both before and during treatment. These findings show that some of the effects of Gemfibrozil on atherosclerotic humans are similar to those of Clofibrate but others are different.     

Activity of antithrombin III and effect of heparin on coagulation in shock

In 16 patients admitted for DIC and shock,series of coagulation tests were carried out prior to and during heparin therapy. Plasma heparin concentrations measured were corresponding to expected levels. In some cases however,considerably higher or lower levels were found. This could be partly explained by release of PF 4 from platelets and by a decreased turnover of heparin because of a malfunction of the kidneys or of the liver. A relation between the effect of heparin on coagulation and the activity of antithrombin III could be established. A diminution of this activity resulted in a diminished or even missing effect of heparin. In some instances,the PTTand the thrombin clotting time were considerably prolonged when FDP were present or when procoagulant factors were diminished. These tests therefore,did not reflect true heparin concentrations in shock. For this reason,regular assays of antithrombin III and of heparin are proposed.