天津医药

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闭塞性周围动脉粥样硬化患者血管内皮损伤的研究

门剑龙1,李刚2,任静3   

  1. 1. 天津医科大学总医院；天津大学，天津市生物医学检测技术与仪器重点实验室
    2. 天津大学
    3. 天津医科大学总医院
  • 收稿日期:2010-06-10 修回日期:2010-12-02 出版日期:2011-03-15 发布日期:2011-03-15
  • 通讯作者: 门剑龙

Study on the endothelial cells damage in the patients with peripheral arteriosclerosis obliterans.

  • Received:2010-06-10 Revised:2010-12-02 Published:2011-03-15 Online:2011-03-15
  • Contact: Men Jianlong

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摘要： 目的：研究闭塞性周围动脉粥样硬化患者血管内皮的损伤状态以及对纤溶、凝血系统功能的影响。方法：采用流式细胞仪计数循环内皮细胞（CEC）数量和内皮祖细胞（EPCs）数量。采用ELISA法测定凝血酶-抗凝血酶复合物（TAT）。采用IL ACL-9000型血液凝固仪测定凝血因子Ⅶ活性(FⅦ:A)、纤维蛋白原（FIB）、vW因子（vWF）、组织型纤溶酶原激活物活性（t-PA:A）、纤溶酶原激活物抑制物活性（PAI:A）。结果：患者组PAI:A、FⅦ:A、FIB、vWF:Ag、TAT和CEC高于对照组，差异有统计学意义（P<0.01）；患者组EPCs低于对照组，差异有统计学意义（P<0.01）。vWF:Ag与FⅦ:A、PAI:A和TAT显著正相关（P<0.01）。结论：闭塞性周围动脉粥样硬化患者的血管内皮存在较为严重的损伤，内皮细胞大量脱落，且损伤后的修复能力不足，从而导致纤溶和凝血系统的功能异常，纤溶系统减弱和凝血系统活性增强与血管内皮损伤程度相关，导致患者血栓风险增加。

关键词: 闭塞性周围动脉粥样硬化, 内皮细胞损伤, 纤溶, 凝血, 紊乱

Abstract: Objective Study on the endothelial cells damage and the effect of the fibrinolysis and coagulation system in the patients with peripheral arteriosclerosis obliterans. Methods The flow cytometry was used to measure the circulating endothelial cell（CEC） and the endothelial progenitor cells（EPCs）. Thrombin-antithrombin complex(TAT) was measured by ELISA.Using the IL ACL-9000 blood coagulation instrument assay the factor Ⅶ activity（FⅦ:A）， fibrinogen（FIB），von Willebrand Factor antigen(vWF:Ag)，tissue plasminogen activator activity（t-PA:A） and plasminogen activator inhibitor activity（PAI:A）. Results Compared the control group with the patients group, the level of the PAI:A, FⅦ:A, FIB, vWF:Ag and the CEC were increased obviously（P<0.01）, and the level of the EPCs was decreased obviously（P<0.01） in the patients group. There was the strong positive relationship between the vWF and FⅦ:A（P<0.01），between the PAI:A and the CEC，and between PAI:A and vWF:Ag（P<0.01）. Conclusions There was severe damage with blood vascular endothelial cell in the patients with peripheral arteriosclerosis obliterans, increased numbers of circulating endothelial cells shed off vascular wall, and it was weak for the repair ability after the endothelial injury, so it led the fibrinolysis and coagulation system to disorder, there was relationship between the dysfunction for fibrinolysis and coagulation system and the endothelial cells damage，the thrombosis risk increased remarkly finally in the patients.

Key words: peripheral arteriosclerosis obliterans, endothelial cells damage, fibrinolysis, coagulation, disorder