【摘要】 本研究检测慢性肾功能衰竭尿毒症期患者血浆凝血因子Ⅶ (FⅦ )水平并初步探讨其影响因素。选取 3 0例慢性肾功能衰竭尿毒症期患者 ,采用一期凝血法分别检测血液透析前及血液透析 1月后血浆凝血因子Ⅶ水平∶因子Ⅶ活性 (FⅦ∶C) ;采用重组可溶性组织因子一期凝血法检测活化因子Ⅶ (FⅦa) ;采用酶联免疫吸附法检测因子Ⅶ抗原 (FⅦAg)。结果显示 :①尿毒症患者血液透析前FⅦa、FⅦ∶C和FⅦAg水平分别为 4 .0 0± 0 .86μg/L、( 14 8.5± 4 0 .4 ) %和 ( 99.8± 2 1.1) % ,健康对照则分别为 2 .77± 1.0 2 μg/L、( 113 .1± 3 3 .0 ) %和 ( 73 .7± 18.3 ) % ,尿毒症患者的FⅦa ,FⅦ∶C ,FⅦAg水平与健康对照比较显著增高 (P 值均 <0 .0 5 ) ;②尿毒症患者血液透析后FⅦa,FⅦ∶C和FⅦAg水平分别为 5 .5 6± 1.4 5 μg/L、( 2 0 0 .8± 68.7) %和 ( 12 4 .1± 19.3 ) % ,与血液透析前相比较 ,FⅦa,FⅦ∶C和FⅦAg水平均显著增高 ( P值均 <0 .0 5 ) ;③尿毒症患者血液透析前FⅦAg ,FⅦ∶C及FⅦa水平与血尿素氮水平呈正相关 (相关系数分别为r =0 .3 7,P <0 .0 5 ;r =0 .4 0 ,P <0 .0 5 ;r =0 .2 8,P <0 .0 5 ) ;与血肌酐水平亦呈正相关 (相关系数分别为r =0 .14 ,P <0 .0 5 ;r =0 .2 3 ,P <0 .0 5 ;r =0 .18,P更多还原

【Abstract】 This study was aimed to investigate coagulation factor Ⅶ level in uremic patients with chronic renal failure and to explore theirs influence factors. The plasma levels of coagulation factor Ⅶ were detected in 30 uremic patients with chronic renal failure before and after hemodialysis for 1 month, the factor Ⅶ activity (FⅦ:C) was determined by one stage coagulation method, while activated factor Ⅶ (FⅦa) was measured by one stage coagulation method using recombinant soluble tissue factor, and factor Ⅶ antigen was detected by ELISA. The results showed that: (1)The FⅦa, FⅦ:C and FⅦAg levels in chronic uremic patients before hemodialysis were 4.00±0.86 μg/L, (148.5±40.4)% and (99.8±21.1)% respectively, which were significantly increased, as compared with healthy controls [2.77±1.02 μg/L, (113.1±33.0)% and (73.7±18.3)% respectively, P<0.05]. (2)After hemodialysis the FⅦa, FⅦ:C and FⅦAg levels in uremic patients significantly enhanced to 5.56±1.45 μg/L, (200.8±68.7)% and (124.1±19.3)% respectively (P<0.05). (3)The abnormal increase of coagulation factor Ⅶ was positively correlated with levels of blood uria nitrogen and serum creatinine before hemodialysis but not after hemodialysis. It is concluded that the enhanced levels of coagulation factor Ⅶ in chronic uremic patients suggested abnormal activated state, herperactivity and elevated production of factor Ⅶ which correlated with renal functional injury. The abnormality of factor Ⅶ in uremia may be aggravated by hemodialysis. Coagulation factor (FⅦ) may be a risk factor for cardiovascular events in uremic patients who especially had been accepted long term hemodialysis.更多还原