急性下肢深静脉血栓形成P-选择素与D-二聚体的变化及意义

目的 探讨下肢深静脉血栓形成(DVT)患者P-选择素与D-二聚体变化及其临床药物干预后的变化.方法 用流式细胞术(FCM),以单克隆抗体为探针测定40例下肢DVT患者及20例健康人P-选择素阳性表达率,应用免疫方法测定D-二聚体(D-dimer)含量.结果 DVT组在发病的早期P-选择素与D-二聚体阳性表达率均高于对照组(P均＜0.05),溶栓抗凝等治疗后不同时间P-选择素与D-二聚体阳性表达率呈降低趋势,其中应用奥扎格雷钠组与非奥扎格雷钠组比较P-选择素阳性表达率有显著差异.D-二聚体的变化无显著差异.出院1个月后P-选择素与D-二聚体含量明显降低,但P-选择素阳性表达率较正常人偏高.结论 急性DVT患者早期体内血小板活化,纤维蛋白溶解处于亢进状态;奥扎格雷钠能降低血小板活化;P-选择素,D-二聚体可做为DVT诊断的指标之一;出院后DVT患者仍是血栓形成的高危人群,需要定期随访.

Changes of P-selectin and D-dimer in acute patients with deep venous thrombosis

Objective To evaluate the statues of P-selectin and chang of D-dimer in vivo in patients with deep venous thrombosis(DVT)and to observe how to vary under interneving of medicines.Methods P-selectin and D-dimer of fourty patients and twenty normal subjects were fluo-rescencelabled with its corresponding monoclonal antibodies by flow cytometry(FCM)and immune method respectively.Results In the early stage,P-selectin and D-dimer of patients with DVT is higher than that in normals,and they significantly decreased in different time after patients were treated.Compared with patients who were used on-sodium ozagrel,patients used sodium ozagrel have different P-selectin(P＜0.05),but D-dimer was similar(P＞0.05)after fourteen days.One month later,P-selectin and D-dimer of DVT patients were lower.However,the positive rate of P-selectin of DVT was still higher than normal subjects.Conclusions The platelet has been actived in vivo in patients with DVT,so do fibrinolysis.Sodium ozagrel can decrease the action of platelet.P-selectin and D-dimmer may be used in diagnose.Post-discharge patients are still high-risk group and must be followed-up regularly.