FⅫa受抑稀释凝血活酶试验反映凝血过程的研究.docVIP

???? FⅫa受抑稀释凝血活酶试验?反映凝血过程的研究 ???? ????　【摘要】　目的　建立反映两阶段凝血过程的筛选试验。方法　在抑制FⅫa活性的条件下，观察不同凝血活酶浓度对不同的血浆凝固时间的影响。FⅩa活性测定采用生色底物法。结果　①在凝血活酶浓度较高(1∶1，1∶10)时，混合正常血浆与乏FⅪ血浆的FⅫa受抑稀释凝血活酶时间(FⅫai DTT)接近；在凝血活酶浓度较低［(1∶100）～（1∶4000)］时，FⅫai DTT顺序为乏FⅧ与乏FⅨ血浆乏FⅪ血浆混合正常血浆。②以免疫法消耗FⅪ引起FⅫai DTT延长，向乏FⅪ血浆加入FⅪ导致FⅫai DTT缩短。③在FⅫai DTT试验的不同时间(10～80s)以水蛭素阻断α凝血酶越早，FⅩa生成量越少；在相同条件下，FⅩa生成量顺序为富血小板血浆乏血小板血浆乏FⅪ血浆。结论　①研究结果支持凝血过程两阶段假说，并证实FⅪ与血小板在放大阶段中的重要作用。②FⅫai DTT作为反映凝血过程的筛选试验也许是可行的。　　【关键词】　血液凝固；　血液凝固因子；　血小板 Factor Ⅻa-inhibited diluted thromboplastin time can reflect coagulation process HE Shilin, XIONG Shilong, HE Rong, et al.Department of Hemostatic Physiology, Hunan Medical University, Changsha　410078，China 　　【Abstract】　Objective　To establish a screening test that can reflect two stages of coagulation process. Methods　 With FⅫa being blocked, the effects of various dilution of thromboplastin on clotting time were observed. FⅩa activity was determined by chromogenic assay. Results　①At high concentration of thromboplastin, FⅫa-inhibited diluted thromboplastin time (FⅫai DTT) of pooled normal plasma and FⅪ deficient plasma was very similar, but at low concentration, FⅫai DTT was in order of FⅧ and FⅨ deficient plasma FⅪ deficient plasmapooled normal plasma. ②FⅪ consumption by immunologic method induced FⅫai DTT of pooled normal plasma prolonged,and addition of FⅪ to FⅪ deficient plasma shortened FⅫai DTT. ③α-thrombin blocked by hirudin at different time (10～80 seconds) resulted in decreased FⅩa generation, and the earlier the block, the more the decrease. Under the same condition, the amount of FⅩa generation was in order of platelet-rich plasmaplatelet-poor plasmaFⅪ deficient plasma. Conclusion　①Our data support the two-stage hypothesis and confirm the important role of FⅪ in the amplification stage. ②FⅫai DTT as a screening test for coagulation process may be practicable.　　【Key words】　Blood coagulation;　Thromboplastin；　Platelet 　　经典凝血假说认为凝血机制存在两个启动过程［1］。接触激活FⅫ启动内在途径，表达或释放组织因子(tissue factor,TF)启动外在途径。两条途径的