静脉血栓栓塞症患者活化蛋白C抗性及凝血因子Ⅴ活性和基因多态性研究_药学论文.docVIP

静脉血栓栓塞症患者活化蛋白C抗性及凝血因子Ⅴ活性和基因多态性研究_药学论文 静脉血栓栓塞症患者活化蛋白C抗性及凝血因子Ⅴ活性和基因多态性研究_药学论文 作者：韩轩茂，任景芳，郝斌，曹文东，刘秀娥， 侯丽虹， 郭志萍，于斌，王学峰，丁秋兰，杨林花【摘要】 　　 本研究旨在观察静脉血栓栓塞患者凝血因子Ⅴ（FactorⅤ, FⅤ）活性改变，检测活化蛋白C抗性（activated protein C resistance, APCR）和凝血因子Ⅴ基因FⅤLeiden、 FⅤCambridge、FⅤHong Kong、 FⅤAsp79His和FⅤI359T多态性。对95例静脉血栓栓塞患者（其中下肢深静脉血栓79例，肺栓塞4例，下肢深静脉血栓合并肺栓塞12例）和95例正常对照者。应用限制性内切酶片段长度多态性测定FV Leiden、FⅤCambridge和FⅤHong Kong多态性， 用MassARRAYTM技术检测FⅤAsp79His、FⅤI359T多态性。以一期法和校正的APTT试验分别对其中的65例静脉血栓栓塞患者和60例正常对照者行凝血因子Ⅴ活性水平和活化蛋白C抵抗检测。结果表明：静脉血栓栓塞患者血浆凝血因子Ⅴ活性水平（108.03%±28.29%）高于对照组（95.17%±29.75%），差异有显著性统计学意义（P=0.008)；静脉血栓栓塞组活化蛋白C抵抗阳性13例（20.0%），对照组3例（5.0%），二组比较，有统计学意义（P=0.012）。二组均未发现FV Leiden、FⅤCambridge、FⅤHong Kong、 FVAsp79His和FV I359T多态性。结论：凝血因子Ⅴ活性升高和活化蛋白C抵抗是静脉血栓栓塞的危险因素，但APCR与FⅤLeiden、FⅤCambridge、FⅤHong Kong、 FⅤAsp79His和FⅤI359T多态性无关。 【关键词】 静脉血栓栓塞 活化蛋白C抵抗 凝血因子Ⅴ 基因多态性 　　 Analysis of Activated Protein C Resistance, Factor V Coagulation Activity and Gene Polymorphisms in Patients with Venous Thromboembolism Abstract The study was aimed to investigate the factor V coagulation activity (FⅤ:C), and to evaluate FⅤgene polymorphisms and activated protein C resistance (APCR) in the patients with venous thromboembolism (VTE). 95 patients with VTE and 95 normal controls were investigated for FⅤ gene polymorphisms. FV Leiden, FⅤCambridge, and FⅤHong Kong were detected by PCR, MnlI and BstNI digestion respectively. FⅤAsp79His and FⅤI359T were detected by MassARRAYTM. FⅤ:C and APCR in 65 patients with VTE and 60 normal controls were determined by a onestage clotting method and the APTTbased assays respectively. The results showed that the mean levels of plasma FⅤ:C were significantly higher in VTE group than that in controls (108.03%±28.29% vs 95.17%±29.75%) (P=0.008), the incidence of APCR were 20.0% (13 of 65 cases) in patients with VTE and 5.0% (3 of 60 cases) in normal controls (P=0.012）. FV Leiden, FⅤCambridge, FⅤHong Kong, FⅤAsp79His and FⅤI359T mutations were not found in two groups. It is concluded that the increased