摘要
目的研究慢性高原病患者发生血栓与血浆EMP和P-选择素水平之间的关系。方法以20例慢性高原病合并血栓患者(CMS+T组)、40例慢性高原病患者(CMS组)、40例高原健康人(control组)为研究对象。取外周血采用流式细胞仪测定各组的EMPs水平、ELISA法测定P-选择素水平,并检测各组血红蛋白、血小板及凝血功能,结合患者的临床资料进行统计学分析。结果①血浆EMPs、P-选择素水平在control、CMS、CMS+T组依次升高,各组间比较差异具有统计学意义(P<0.05);②CMS+T组D-二聚体水平高于CMS、Control组(P<0.05);③CMS组和CMS+T组PT、APTT长于Control组(P<0.05),CMS组和CMS+T组PLT低于Control组(P<0.05);④EMPs是慢性高原病血栓发生的独立危险因素,OR=9.947,P=0.005,PT是慢性高原病预防血栓发生的保护性因素,OR=0.134,P=0.017;⑤慢性高原病合并血栓患者血浆EMPs与P-选择素呈中度正相关(r=0.614,P=0.004),EMPs与D-二聚体呈中度正相关(r=0.447,P=0.048)。结论①慢性高原病患者存在凝血功能异常,具有出血和血栓发生的双重风险;②慢性高原病合并血栓患者血浆EMPs和P-选择素水平升高,血浆EMPs与血栓有一定的相关性;③血浆EMPs是慢性高原病血栓发生的独立危险因素,PT是慢性高原病预防血栓发生的保护性因素。
Objective To find out the relationship between the levels of plasma EMP and P-selectin in patients with thrombosis(TRB)of Chronic Mountain Sickness(CMS).Methods Twenty patients with CMS combined with thrombosis(CMS+T group),40 patients with CMS(CMS group),and 40 healthy people living in high altitude(Control group)were studied.The levels of EMPs in each group were detected by flow cytometry.The levels of P-selectin were detected by ELISA,and the coagulation function of each group were detected.The clinical data of the patients were statistically analyzed.Results①The levels of EMPs and P-selectin were gradually increased in control group,CMS and CMS+T groups,and the differences among the groups were statistically significant(P<0.05).②The level of D-Dimer in the CMS+T group was higher than that in the CMS group and the control group(P<0.05).③The PT and APTT in the CMS group and the CMS+T group were longer than those in the Control group(P<0.05),the PLT in the CMS group and the CMS+T group were lower than those in the control group(P<0.05).④EMPs is an independent risk factor for thrombosis in CMS with an OR=9.947 and P=0.005,PT is a protect factor for thrombosis in CMS with an OR=0.134 and P=0.017.⑤The levels of EMPs in CMS+T group and CMS group were positively correlated with P-selectin(r=0.614,P=0.004)and D-Dimer(r=0.447,P=0.048).Conclusions①Patients with CMS both have risks of hemorrhage and thrombosis.②EMPs is independent risk factors and PT is a protect factor for thrombosis in CMS.③The levels of EMPs and P-selectin are elevated in patients with chronic mountains sickness and thrombosis,and EMPs have a certain correlation with thrombosis.
作者
王卓亚
杨发满
汪雪萍
旦增诺扬
WANG Zhuoya;YANG Faman;WANG Xueping;DANZENG Nuoyang(Qinghai University Affiliated Hospital,Qinghai 810001,China;Research Center for High Altitude Medicine,Qinghai University,Qinghai 810001,China)
出处
《中国高原医学与生物学杂志》
CAS
2019年第4期232-237,共6页
Journal of Chinese High Altitude Medicine & Biology
基金
青海省卫生健康委青年课题项目(2016-wjqn-02)
关键词
高原病
内皮细胞微粒
P-选择素
血栓
凝血功能
Mountain Sickness
endothelial microparticles
P-selectin
thrombus
coagulation
