Vascular Center, Malmö University Hospital, Malmö, Sweden.
Thromb Res. 2010 Feb;125(2):171-7. doi: 10.1016/j.thromres.2009.07.018. Epub 2009 Oct 1.
Elevated levels of markers for thrombin activation are associated with plaque echogenicity and degree of stenosis in patients with carotid artery stenosis. The Activated Protein C-Protein C Inhibitor (APC-PCI) complex reflects activation of the Protein C system and is a measure of thrombin generation. The aim of the present study was to examine APC-PCI complex in patients undergoing thrombendartherectomy for carotid artery stenosis, and to relate the findings to clinical characteristics and plaque morphology as determined by ultrasound.
Blood was obtained from 125 patients (39 female, median age 71 years) with carotid artery stenosis admitted from September 2005 to May 2007. The APC-PCI complex was measured using a sandwich immunofluorometric method and compared to an age- and sex-matched healthy control-group. Clinical and demographic characteristics, routine laboratory markers and ultrasound characteristics were analysed using univariate and multivariate analysis.
APC-PCI complex concentration was significantly increased in patients with carotid artery stenosis (median 0.21 microg/L; 10th to 90th percentile 0.15-0.36) compared to a healthy control-group (0.19 microg/L; 0.11-0.31; P=.009). There was no significant difference in APC-PCI-values between asymptomatic (n=48) and symptomatic (n=77) patients with carotid artery stenosis (0.22 vs. 0.20 microg/L; p=0.626). Patients with minor stroke (n=31) had a higher median APC-PCI-concentration (0.27 microg/L; 0.15-0.63) than patients with amaurosis fugax (0.19 microg/L; 0.15-0.36) or transient ischemic attack (0.21 microg/L; 0.12-0.36) (p=0.016). No association was found between APC-PCI-values and the degrees of carotid artery stenosis or the time from the latest neurological symptoms to blood sampling. Patients with echolucent plaques had significantly lower APC-PCI concentrations (0.20 microg/L; 0.14-0.35 vs. 0.24 microg/L; 0.15-0.60; p=0.043), according to the Gray-Weale classification.
Patients with carotid artery disease exhibit increased concentrations of APC-PCI compared to a healthy control-group, particularly those patients with echogenic plaques, who have significantly higher APC-PCI levels than patients with echolucent plaques.
在患有颈动脉狭窄的患者中，凝血酶激活标志物水平升高与斑块回声强度和狭窄程度相关。活化蛋白 C-蛋白 C 抑制剂（APC-PCI）复合物反映蛋白 C 系统的激活，是凝血酶生成的一个指标。本研究的目的是检测行颈动脉内膜切除术的颈动脉狭窄患者的 APC-PCI 复合物，并将其与通过超声确定的临床特征和斑块形态相关联。
从 2005 年 9 月至 2007 年 5 月期间入院的 125 例颈动脉狭窄患者（39 例女性，中位年龄 71 岁）中采集血液。使用夹心免疫荧光测定法测量 APC-PCI 复合物，并与年龄和性别匹配的健康对照组进行比较。使用单变量和多变量分析来分析临床和人口统计学特征、常规实验室标志物和超声特征。
与健康对照组（0.19μg/L；0.11-0.31）相比，颈动脉狭窄患者的 APC-PCI 复合物浓度显著升高（中位数 0.21μg/L；10 至 90 百分位数 0.15-0.36；P=0.009）。无症状（n=48）和有症状（n=77）颈动脉狭窄患者的 APC-PCI 值无显著差异（0.22 与 0.20μg/L；p=0.626）。发生小卒中（n=31）的患者的 APC-PCI 浓度中位数（0.27μg/L；0.15-0.63）高于发生一过性黑矇（0.19μg/L；0.15-0.36）或短暂性脑缺血发作（0.21μg/L；0.12-0.36）的患者（p=0.016）。APC-PCI 值与颈动脉狭窄程度或从最新神经症状到采血的时间之间没有关联。根据 Gray-Weale 分类，回声较强的斑块患者的 APC-PCI 浓度明显较低（0.20μg/L；0.14-0.35 与 0.24μg/L；0.15-0.60；p=0.043）。
与健康对照组相比，患有颈动脉疾病的患者 APC-PCI 浓度升高，尤其是回声较强的斑块患者，其 APC-PCI 水平明显高于回声较弱的斑块患者。
