The Correlative Study Of Coagulation,Anticoagulation State And Coagulation Factors Level In CMS Patients

Objective: Through the determination of coagulation factors,fibrinolysis and anticoagulant indexes in CMS patients,clear the changes of blood coagulation factor(FⅠ、FⅡ、FⅤ、 FⅦ、 FⅧ、FⅨ、 FⅩ、 FⅪ、FⅫ),D-dimer,FDP,protein C(PC),protein S(PS)and antithrombin-Ⅲ(AT-Ⅲ)in the CMS patients.To investigate the possible causes of prolongation of PT and APTT in CMS patients,and clear the correlation between PT,APTT and blood coagulation factor(FⅠ、FⅡ、FⅤ、FⅦ、 FⅧ、FⅨ、 FⅩ、 FⅪ、FⅫ),D-dimer,FDP,protein C(PC),protein S(PS)and antithrombin-Ⅲ(AT-Ⅲ).Methods: 60 CMS patients,all male and Han,were selected from the Affiliated Hospital of Qinghai University.Among them,30 patients have normal PT and APTT,and 30 patients have prolonged PT and APTT.30 healthy subjects,all male and Han,were selected from the Physical Examination Center of the Affiliated Hospital of Qinghai University.The venous blood of all subjects was extracted to determine of the blood routine,PT,APTT,D-dimer,the AT-Ⅲ,FDP and the level of blood coagulation factor(FⅠ、FⅡ、FⅤ、 FⅦ、 FⅧ、FⅨ、 FⅩ、 FⅪ、FⅫ),PC,PS.Results:1.The platelet count of CMS patients was lower than that of healthy group(P<0.05).2.The plasma concentrations of FⅤ、 FⅦ、 FⅧ、FⅨ、 FⅩ、 FⅪ、FⅫ in CMS patients was lower than those in the healthy group(P < 0.05).The plasma concentration of FⅡ and FⅤ in CMS patients who have prolonged PT and APTT was lower than those in CMS patients who have normal PT and APTT(P<0.05).3.The levels of Plasma protein C and protein S in CMS patients were higher than those in healthy group(P<0.05);The level of D-dimer in CMS patients was higher than that in healthy group(P<0.05).4.The activity of AT-Ⅲ of CMS patients was lower than that of healthy group(P < 0.05).The activity of AT-Ⅲ in CMS patients complicated with prolonged PT and APTT was lower than that in CMS patients complicated with PT and normal APTT(P<0.05).5.In the CMS patients who have prolonged PT and APTT,the APTT negatively correlated with the plasma concentrations of FⅤ(P < 0.05),the level of D-dimer negatively correlated with the plasma concentrations of FⅪ(P < 0.05).Conclusion:1.The levels of FⅤ、 FⅦ、 FⅧ、FⅨ、 FⅩ、 FⅪ、FⅫin the CMS patients were lower than the control group,consider that the blood coagulation dysfunction of CMS patients may be associated with the decrease of coagulation factors.2.The levels of FⅡand FⅤ in the CMS patients who have prolonged PT and APTT were lower than those in the CMS patients have normal PT and APTT.and the APTT negatively correlated with the plasma concentrations of FⅤ.Consider that the prolong of APTT in CMS patitents was associated with the decrease of FⅤ.3.Clear that the D-dimer level of CMS patients was higher than that of healthy control group,and consider the possibility of secondary fibrinolytic hyperactivity in CMS patients.4.It is confirmed that there was difference in levels of PC and PS between the CMS patients and control group,which might be related to endothelial cell damage.The activity of AT-Ⅲ in the CMS patients was lower than the control group,the activity of AT-Ⅲ in the CMS patients who have prolonged PT and APTT was lower than those in the patients who have normal PT and APTT;consider that the AT-Ⅲ participates in anticoagulant mechanism of CMS patients,and it was more obvious that the AT-Ⅲ participates in anticoagulant mechanism of CMS patients who have prolonged PT and APTT.