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目的 研究系统性红斑狼疮 (SLE)患者血浆蛋白C(PC)、蛋白S(PS)活性水平、活化蛋白C抵抗 (APCR)和狼疮样抗凝物质 (LA)阳性率 ,探讨SLE患者发生血栓的机制。方法 用凝固法在SysmexCA 15 0 0、CA 6 0 0 0全自动血凝仪上检测 4 4例SLE患者和 4 0例正常对照的血浆PC、PS活性、活化蛋白C反应性和LA。结果 SLE组血浆PC、PS活性分别为 (10 6 5± 14 3) %、(98 8± 19 6 ) % ,与对照组相比差异均无显著性意义 (均P >0 0 5 )。SLE组APCR阳性率为 36 4 % ,明显高于对照组 2 5 % (P <0 0 1) ,SLE组LA阳性率为 18 2 % ,明显高于对照组 0 % (P <0 0 5 )。相关性分析表明LA、APCR阳性均与SLE患者血栓形成有关 (均P <0 0 5 ) ,LA和APCR之间有相关性 (P <0 0 5 )。结论 SLE患者血栓形成与血浆PC、PS活性无关 ,与APCR、LA有关 ,且APCR与LA密切相关 ,APCR、LA是SLE患者血栓形成危险性增高的指标。
Objective To investigate the levels of plasma protein C (PC), protein S (PS) activity, activated protein C resistance (APCR) and lupus -like anticoagulant (LA) in patients with systemic lupus erythematosus (SLE) mechanism. Methods The plasma PC, PS activity, activated protein C reactivity and LA in 44 SLE patients and 40 normal controls were detected by coagulation method on Sysmex CA 150 000, CA 60 000 automatic coagulation analyzer. Results The plasma levels of PC and PS in SLE group were (10 6 ± 14 3)% and (98 8 ± 19 6)%, respectively, which were not significantly different from those in control group (all P 0 05). The positive rate of APCR in SLE group was 36.4%, which was significantly higher than that in control group (25%, P0.01). The positive rate of LA in SLE group was 18.2%, which was significantly higher than that in control group (P0.05) . Correlation analysis showed that both LA and APCR positive were associated with thrombosis in patients with SLE (all P <0.05), and there was a correlation between LA and APCR (P <0.05). Conclusion The thrombosis in patients with SLE has nothing to do with plasma PC, PS activity, APCR and LA, APCR and LA are closely related. APCR and LA are the risk factors of thrombosis in patients with SLE.