He W J, Hu Yu, Zhang X P, Hong M, Guo T, Wei W N, Song S J
Institute of Hematology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Eur J Med Res. 2008 Feb 25;13(2):47-51.
There is close relationship between abnormal coagulation system and progression of coronary heart disease (CHD), our purpose is to evaluate the contribution of hematologic factors and some other risk factors to the development of coronary heart disease (CHD) in Chinese population.
56 patients with CHD at admission and 54 controls were enrolled. Plasma levels of protein C, free protein S, total protein S, thrombomodulin, activated factor VII (FVIIa), factor VII:Ag, P-selectin, tissue-type plasminogen activator, plasminogen activator inhibitor-1 were measured by enzyme linked immunosorbent assay, activity of tissue factor (aTF) by chromogenic activity assay, and activated protein C (APC) ratio, prothrombin time, aPTT, fibrinogen, D-dimmer and thrombin time by full-automated coagulation analyzer.
Compared with controls, plasma level of thrombomodulin, FVIIa, factor VII:Ag and aTF were raised in CHD group (p<0.05, 0.001, 0.05, and 0.05, respectively). The average APC ratio in CHD group was lower than that in controls (p<0.001). The result of binary logistic regression analysis showed that activated factor VII (OR2.680, 95%CI1.539-4.665) and tissue factor activity (OR1.019, 95%CI1.004-1.035) were risk factors and high density lipoprotein (OR0.008, 95%CI0-0.478) and activated protein C ratio (OR0.001, 95%CI0-0.011) were protective factors for CHD.
Low activated protein C ratio, elevated tissue factor activity and increased activated factor VII in plasma may contribute to development of coronary heart disease.
凝血系统异常与冠心病(CHD)进展密切相关,本研究旨在评估血液学因素及其他危险因素对中国人群冠心病发生发展的影响。
选取56例入院时确诊为冠心病的患者及54例对照者。采用酶联免疫吸附测定法检测血浆蛋白C、游离蛋白S、总蛋白S、血栓调节蛋白、活化因子VII(FVIIa)、因子VII:Ag、P-选择素、组织型纤溶酶原激活剂、纤溶酶原激活剂抑制剂-1水平;采用发色底物法检测组织因子(aTF)活性;采用全自动凝血分析仪检测活化蛋白C(APC)比值、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、D-二聚体及凝血酶时间。
与对照组相比,冠心病组血浆血栓调节蛋白、FVIIa、因子VII:Ag及aTF水平升高(分别为p<0.05、0.001、0.05及0.05)。冠心病组平均APC比值低于对照组(p<0.001)。二元logistic回归分析结果显示,活化因子VII(OR2.680,95%CI1.539-4.665)和组织因子活性(OR1.019,95%CI1.004-1.035)是冠心病的危险因素,高密度脂蛋白(OR0.008,95%CI0-0.478)和活化蛋白C比值(OR0.001,95%CI0-0.011)是冠心病的保护因素。
血浆中活化蛋白C比值降低、组织因子活性升高及活化因子VII增加可能促进冠心病的发生发展。