关键词：红斑狼疮；系统性；血栓调节蛋白
【摘要 】 目的 通过血浆可溶性血栓调节蛋白(sTM)的检测，探讨血管内皮细胞损伤与SLE临床表现、凝血障碍的关系。方法 采用酶联免疫吸附法(ELISA)检测40例SLE患者血浆sTM水平。结果 ①SLE患者血浆sTM水平显著增高，并与疾病活动性呈正相关，而与血沉、ANA、补体C3间无显著相关性；②SLE患者中有肾损组血浆sTM水平显著高于无肾损组，并与24h尿蛋白定量呈正相关；③SLE患者血浆sTM水平与纤维蛋白原、纤维蛋白原降解产物呈正相关。结论 SLE患者存在血管内皮细胞的损伤，并与高凝、低纤溶状态有关，血浆sTM检测可作为判断SLE疾病活动性及严重程度的指标。
Detection of Plasma Thrombomodulin in Patientswith Systemic Lupus Erythematosus and Its Clinical Significance
CHAO Yuelan, SUN Guojun, LU Xinguo, et al. Departmentof Dermatology, Second Affiliated Hospital, Zhejiang Medical University, Hangzhou 310009
【Abstract 】 Objective Toinvestigate the relationship between endothelial cell injury and abnormality ofcoagulation and clinical manifestation in SLE patients by detection of plasma solublethrombomodulin(sTM). Methods Levels of plasma soluble thrombomodulin in40 SLE patients were determined by enzyme-linked immunosorbent assay (ELISA). Results ①The plasma levels of sTM in 40 SLE patients were significantly higher than those in 20controls,and they showed significant correlation with disease activity. But no significantcorrelation was found between sTM levels and erythrocyte sedimetation rate, ANA,complement C3 levels; ② The plasma levels of plasma sTM in the patients with renallesion were significantly higher than those without renal lesion, and there was a positivelinear correlation between the sTM level and the quantity of 24 hour urine protein; ③there was a significant correlation between plasma sTM levels and fibrinogen(Fbg) orfibrinogen degradation product levels in SLE patients. Conclusion Thereis injury of vascular endothelial cells in SLE patients, which is related tohypercoagulative state and low level of fibrinolytic function, and the determination ofplasma sTM level may be used as an index in monitoring the disease activity and severityin SLE patients.
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