下肢深静脉血栓形成患者溶栓前后凝血、抗凝和纤溶活性改变的研究

目的观察下肢深静脉血栓（LDVT）患者溶栓前后凝血、抗凝和纤溶指标的变化，以探讨出凝血、纤溶活性改变与LDVT患者溶栓后高血栓发生率的相关性。方法测定50例LDVT患者溶栓前后抗凝血浆标本的抗凝血酶活性（AT：A）、纤维蛋白原（FIB）、纤溶酶原活性（PLG：A）、组织型纤溶酶原激活物抗原性（t—PA：Ag）、纤溶酶原活性抑制剂-1抗原性（PAI：Ag）、血浆D-二聚体（D-D）、血管性血友病因子（VWF）、Ⅷ促凝活性（Ⅷ：C）、凝血因子Ⅻ活性（Ⅻ：C）；并取32例健康体检者作对照。结果AT：A、PLG：A、t—PA：Ag、Ⅻ：C在溶栓前明显低于对照组（P〈0．01），溶栓后升高（P〈0．05或P〈0．01），其中AT：A、PIG：A、Ⅻ：C仍低于对照组（P〈0．05或P〈0．01），而t-PA：Ag无显著性差异（P〉0．05）；FIB、PAI：A、D-D、Ⅷ：C、VWF在溶栓前显著高于对照组（P〈0．01），溶栓后下降（P〈0．05或P〈0．01），其中PAI：A、D-D、Ⅷ：C、VWF下仍明显高于对照组（P〈0．05或P〈0．01），而FIB无显著性差异（P〉0．05）。结论出凝血系统机能紊乱、纤溶-抗纤溶系统失衡与LDVT患者溶栓后血栓的发生可能有密切的关系。

Study of changes of procoagulant, anticoagulant and fibrinolysis in patients withdeep vein thrombosis pretherapy between posttherapy

Objective Sutdy of changes of procoagulant,anticoagulant and fibrinolysis in patients withdeep vein thrombosis pretherapy between psttherapy.Methods Blood samples from fifty patients with deep veins thrombosis pretherapy tetween posttherapy and thirty two normal people(control group) were obtained to measure antithrombin activity(AT:A),von willabrand factor(VWF),FVIII coagulant activity(VIII:C),D-dimer(D-D),plasminogen activity(PLG:A),FXII:C coagulant activity(XII:C),tissue plasminogen activator antigen(t-PA:Ag),plasminogen activator inhibitor-1 antigen(PAI:Ag) respectively.Results The AT:A,PLG:A,t-PA:Ag,XII:C of pretherapy was lower evidently than that of pretherapy(P<0.01) and it increased after therapy(P<0.05),the AT:A,PLG:A,XII:C still lower than control group he data showed significant increase in PLT and PCT by therapy(P<0.05 or P<0.01) while t-PA:Ag changed insignificantly(P>0.05);The FIB,PAI:A,D-D,VIII:C,VWF of the patients with LDVT were higher evidently than that of pretherapy(P<0.01) and these parameters decreased quickly after therapy(P<0.05 or P<0.01) while PAI:A,D-D,VIII:C VWF still higher than control group(P<0.05 or P<0.01) and FIB changed insignificantly(P>0.05).Conclusion The turbulence of procoagulant and anticoagulant,the unbalance of fibrinolysis and antifibrinolysis were consanguineously correlative to the high-frequency thrombosis of the patients with LDVT after therapy.