| Objective:Thrombosis can cause vascular thrombosis disease,which is seriously harmful to human health,has become one of the highest mortality and morbidity worldwide disease.Common artery thrombosis include coronary heart disease,and cerebral thrombosis;common venous thrombotic disease has deep vein thrombosis and pulmonary thromboembolism.Studies have shown that thromboembolic disease has become one of the highest mortality and morbidity worldwide disease,which is seriously harmful to human health.Previous studies focus more on the role of exogenous coagulation in thrombosis but is lack of enough attention to the role of endogenous blood coagulation system in thrombosis.Recent studies have shown that intrinsic coagulation plays an important role in thrombosis.By comparing the thrombosis patients and the healthy people who needs superficial surgeryof determination of blood coagulation function(PT and INR,APTT,TT),the content of?,?a,?,?a,high molecular weight kininogen and prekallikrein,polyP and platelet count,to observe the changes and regularity of endogenous coagulation factors in patients with arterial thromboembolism,and to explore the role and clinical significance of endogenous coagulation contact component and polyP in thrombosis.Method:Thirteen patients with clinically diagnosed arterial thromboembolism in the lower extremity requiring catheter thrombolysis(6 cases)or incision and thrombectomy(7 cases)as observation group,and at the same time,11 cases of superficial surgery with normal preoperative examination were selected as the control group to this study.All participants signed the informed consent to participate in this study.Data records of the two groups of blood coagulation function(PT and INR,APTT,TT)(solidification method);In both groups,10 ml of venous blood was collected under fasting and in a calm state,and the supernatant was collected by centrifugation.The levels of PK?HK?FXII?FXIIa?FXI and FXIa were measured using human ELISA kit.Using DAPI fluorescence assay to detect the contents of polyP in the plasma,which was extracted with the Lorenz method.Records in the two groups of platelet count(KangFa sheath flow resistance measurement).Results:1 The comparison of contact system component:Levels of human PK in the plasma were higher in the experimental group compared to the control group(585.00±8.08vs.535.89±6.33pg/ml).P<0.05;and levels of the human PK in the blood clots were lower than that in the plasma(505.50±6.01vs.653.50±2.22 pg/ml).P<0.05.HK:Compared with the control group,levels of human HK were higher(12.33±1.01vs.9.36±1.12ug/ml)in the experimental group,P<0.01.Levels of the human HK inthe blood clots were higher than that in the plasma(1.52±0.28vs.2.31±0.62 ug/ml).P<0.05.FXI:Compared with the control group,levels of human FXI was higher(5.28±1.01vs.4.14±0.571U/ml)in the experimental group.P<0.01.And levels of the human FXI inthe blood clots were lower than that in the plasma(4.99±1.14vs.6.06±1.20IU/ml).P>0.05.FXIa:Levels of humanFXIa in the plasma were higher in the experimental group compared to the control group(44.80±2.50vs.32.81±12.84ng/ml),P<0.01.The difference was statistically significant.Levels ofthe human FXIa in the blood clots were lower than that in the plasma(43.01±2.58 vs.57.61±1.99 ng/ml),P<0.05.FXII:Compared with the control group,levels of human FXIIwashigher(79.23±4.23vs.53.97±4.21U/ml)in the experimental group,P<0.01.and Levels of the human FXII in the plasma were lower than that in the blood clots(72.55±2.95 vs.94.75±1.0 U/ml),P>0.05.FXIIa:Levels of human FXIIa in the plasma was lower in the experimental group compared to the control group(104.27±5.39vs.112.83±3.09ng/ml),P>0.05.and Levels of the human FXIIa in the plasma were higher than that in the blood clots(113.05±3.71vs.90.55±2.01 ng/ml),P>0.05.2 The contrast of the clinical indicators of blood coagulation function PT:Compared with the control group,levels of PT were higher(13.80±1.32vs11.50±0.72s)in the experimental group.P<0.01.The difference was statistically significant.INR:Levels of INR in the plasma were higher in the experimental group compared to the control group(1.17±0.41vs1.09±0.22).P>0.05.The difference was not statistically significant.APTT:Compared with the control group,levels of APTT were higher(33.75±2.06vs31.19±1.45s)in the experimental group.P<0.05.The difference was statistically significant.TT:Levels of TT in the plasma were higher in the esperimental group compared to the control group(15.72±1.62vs15.24±0.87s).P>0.05.The difference was not statistically significant.3 The content of Polyphosphate and platelet in comparison with its control group PolyP:Compared with the control group,levels of polyP in the experimental group was lower(569.26±14.15vs.640.5±14.91ug/1).P>0.05,There was no statistical difference between the two groups;Compared with polyP in the blood clots,levels of polyP were lower(633.60±14.61vs.719.65±14.97u/l)in the plasma.P>0.05.The difference was not statistically significant.PLT:The number of PLT of the experimental group was lower than that in the control group(197.83±7.58vs257.40±2.94×109 ?/1).P<0.01.Statistically significant difference.Conclusions:The data shows that the patients with lower limb arterial thrombosis exist disorder phenomenon of the coagulation function,and the expression or activation of endogenous clotting contact system components(former kallikrein,high molecular weight kininogen,FXI,FXII)enhanced in the study;Platelets and polyP may be involved in the formation of arterial thrombosis in the lower extremities,But polyP may only show an increase in concentration locally,which cannot be reflected in circulating plasma.The endogenous coagulation pathway contact activation system involved in arterial thrombosis may be related to increased levels of prekallikrein(PK),high molecular weight kininogen(HK),FXI and FXII,suggesting that the endogenous coagulation pathway contact activation system component may become a new target for the treatment of thromboembolic patients. |
PDF Full Text Request