D'Angelo A, Gerosa S, D'Angelo S V, Mailhac A, Colombo A, Agazzi A, Mazzola G, Chierchia S
Coagulation Service, I.R.C.C.S. H S. Raffaele, Milano, Italy.
Thromb Res. 1994 Jul 15;75(2):133-42. doi: 10.1016/0049-3848(94)90062-0.
Protein S (PS) and protein C (PC) anticoagulant activities and thrombin-antithrombin complex (TAT) were measured in 20 patients with AIS, 25 patients with chronic stable angina (CSA) and a control group (C). Although plasma levels of TAT were significantly elevated in patients with CSA (p < 0.01 vs C), they were much higher in patients with AIS (p < 0.001 vs CSA). PC anticoagulant activity was similar in patients and controls. At variance, PS anticoagulant activity was lower in patients with AIS than in those with CSA and controls (p < 0.05), reflecting differences in total PS and C4B-binding protein (C4B-BP) antigen possibly resulting from involvement in the mechanisms of inflammation, complement activation and acute-phase response. The ratios of anticoagulant PS and PC to procoagulant vitamin K-dependent factors IX and II were reduced in AIS patients (0.05 > p > 0.005 vs C). In addition, the ratios of anticoagulant PC and PS to factor IX were lower in patients with AIS than in those with CSA (p < 0.05). These results indicate that in patients with acute ischemic cardiac syndromes the markedly increased in vivo thrombin generation is associated with an unbalance between coagulant and anticoagulant vitamin K-dependent factors.
对20例急性缺血性卒中（AIS）患者、25例慢性稳定型心绞痛（CSA）患者及一个对照组（C）测定了蛋白S（PS）和蛋白C（PC）的抗凝活性以及凝血酶 - 抗凝血酶复合物（TAT）。虽然CSA患者的血浆TAT水平显著升高（与C组相比，p < 0.01），但AIS患者的TAT水平更高（与CSA组相比，p < 0.001）。患者和对照组的PC抗凝活性相似。不同的是，AIS患者的PS抗凝活性低于CSA患者和对照组（p < 0.05），这反映了总PS和C4B结合蛋白（C4B - BP）抗原的差异，可能是由于参与了炎症、补体激活和急性期反应机制。AIS患者中抗凝性PS和PC与促凝性维生素K依赖性因子IX和II的比率降低（与C组相比，0.05 > p > 0.005）。此外，AIS患者中抗凝性PC和PS与因子IX的比率低于CSA患者（p < 0.05）。这些结果表明，在急性缺血性心脏综合征患者中，体内凝血酶生成的显著增加与促凝和抗凝维生素K依赖性因子之间的失衡有关。
