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[一例先天性蛋白C缺乏症合并肺血栓栓塞病例]

[A case of congenital protein C deficiency with pulmonary thromboembolism].

作者信息

Takeda K, Kumagai H, Hayashi S, Tanio Y, Kawase I, Kishimoto T, Fujiwara M

机构信息

Department of Internal Medicine III, Osaka University School of Medicine, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1994 May;32(5):497-501.

PMID:8084108
Abstract

A 47-year-old woman, with a history of recurrent venous thrombosis in her lower limbs (1988 and June, 1992), was admitted because of pulmonary thromboembolism in the right middle lung lobe. She was given anti-coagulant therapy with warfarin. The consolidation in the right middle lobe disappeared within two months. Hematological examinations concerning the coagulation and fibrinolytic system showed a significant decrease in both the serum concentration and the activity of protein C, a vitamin K-dependent hepatic protein which acts as an anticoagulant by shutting off fibrin formation and stimulating fibrinolysis. Since a sister of the patient also has a history of venous thrombosis, several members of her family were tested for protein C deficiency. The familial study revealed that her sister and mother had both a decreased concentration and depressed activity of protein C, indicating that this is a case of congenital protein C deficiency. Warfarin therapy has been continued to reduce the prothrombin time to 70% of the normal control level, resulting in no further episodes of thrombosis.

摘要

一名47岁女性,有下肢反复静脉血栓形成病史(1988年和1992年6月),因右肺中叶肺血栓栓塞入院。给予华法林抗凝治疗。右中叶的实变在两个月内消失。关于凝血和纤溶系统的血液学检查显示,蛋白C(一种维生素K依赖的肝脏蛋白,通过阻断纤维蛋白形成和刺激纤溶起抗凝作用)的血清浓度和活性均显著降低。由于患者的一名姐妹也有静脉血栓形成病史,对其家族中的几名成员进行了蛋白C缺乏检测。家族研究显示,她的姐妹和母亲蛋白C浓度均降低且活性受抑制,表明这是一例先天性蛋白C缺乏症。继续进行华法林治疗,使凝血酶原时间降至正常对照水平的70%,此后未再发生血栓形成事件。

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