肺血栓栓塞症患者炎性因子和纤溶标志物的检测及相关研究

目的：探讨肺血栓栓塞症（PTE）患者炎性标志物及纤溶标记物活性改变的临床意义。方法选择2008年3月-2012年10月新疆医科大学第一附属医院收治的386例PT E患者（PT E组）及250例健康对照人群（对照组），采用酶联免疫吸附试验（ELISA）方法检测血浆超敏C-反应蛋白（Hs-CRP）、白介素-6（IL-6）、肿瘤坏死因子（TNF-α）、血浆组织型纤溶酶原激活剂（t-PA）、血浆组织型纤溶酶原抑制剂（PAI-1）、D-二聚体（DD）及纤维蛋白原（FIB）水平。结果 PTE组血浆炎性因子Hs-CRP、IL-6、TNF-a水平较对照组明显升高（P ＜0．05）。PTE组血浆纤溶标志物PAI-1、FIB、DD、t-PA水平较对照组明显升高（P ＜0．05）。纠正了年龄、性别、高脂血症、吸烟、糖尿病等危险因素及血浆IL-6、TNF-a、FIB、t-PA水平后，多元Logistic回归分析提示 Hs-CRP、PAI-1、DD水平及肥胖为PT E患者的独立危险因素。结论 PT E患者处于纤溶功能减退及炎症状态，测定炎性因子及纤溶指标有助于早期诊断、减少漏诊及指导临床早期干预治疗。获得性危险因素中肥胖为 PT E患者的独立危险因素，因此在PT E的防治方面对这类人群的生活习惯早期干预特别重要。

Correlation between the levels of inflamatory and fibrinolytic markers in patients wi th pulmonary thromboembolism

Objective To study the inflammatory markers and fibrinolytic activity and explore their clinical significance in patients with pulmonary thromboembolic disease （PTE） .Methods Measure the levels of High-sensitive C-reactive protein （Hs-CRP） ,white referral prime-6 （IL-6） ,tumor necrosis factor （of TNF-a） ,plasma tissue-type fiber plasminogen activator （t-PA） ,plasma tissue-type plasminogen inhibitor （PAI-1） ,D-dimer （DD） and fibrinogen （FIB） level by ELISA to make a comparison between 386 PTE pa-tients （PTE group from March ,2008 to October ,2012） and 250 healthy population（control group） .Re-sults The levels of inflammatory factors such as Hs-CRP ,IL-6 ,TNF-a are significantly higher in PTE group than controls （P 〈0.05） .After adjusting for age ,gender ,hyperlipidimia ,smoking ,diabetes ,and levels of IL-6 ,TNF-a ,FIB and t-PA ,logistic regression analysis indicated that Hs-CRP ,PAI-1 ,DD and obesity are independent risk factors for both for PTE patients .Conclusion PTE patients are in the fibrino-lytic dysfunction and inflammation condition ,and measuring the levels of inflammatory cytokines and fi-brinolysis will contribute to early diagnosis ,reduction of misdiagnosis and guidance to the clinical early in-tervention .In addition ,obesity is an independent risk factors for the patients with PTE .