全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
华西医学  2011 

血栓性血小板减少性紫癜患者血管性血友病因子前肽水平的研究

, PP. 1642-1645

Keywords: 血栓性血小板减少性紫癜,血管性血友病因子前肽,内皮细胞

Full-Text   Cite this paper   Add to My Lib

Abstract:

【】 目的 探讨血栓性血小板减少性紫癜(thromboticthrombocytopenicpurpura,TTP)患者血管内皮损伤程度,以及不同类型TTP之间血管内皮损伤差异性。 方法 纳入2005年4月-2010年12月特发性TTP患者17例(A组),继发性TTP患者15例(B组),骨髓移植相关TTP患者2例(C组),疑似TTP患者11例(D组),共45例;另选取健康体检志愿者为对照组10例(E组)。采用双夹心酶联免疫吸附试验测定血管性血友病因子前肽(vonWillebrandfactorpropeptide,vWFpp)水平。 结果 vWFpp水平为其与正常混合血浆的比值,A组为2.2,B组为2.34,C组为2.795,D组为1.72,E组为1.08。A、B、C、D组患者vWFpp水平与E组比较,差异有统计学意义(P0.05)。 结论 TTP患者vWFpp水平明显增高,提示血管内皮损伤明显,但vWFpp水平不能用于鉴别TTP类型。【Abstract】 Objective Toexploretheseverityofendotheliuminjuryinpatientswiththromboticthrombocytopenicpurpura(TTP)andthedifferencesamongdifferentsubtypesofTTP. Methods Theclinicaldataof45patientswithTTPdiagnosedbetweenApril2005andDecember2010wereretrospectivelyanalyzed.vonWillebrandfactorpropeptide(vWFpp)wasmeasuredbysandwichELISAin17patientswithidiopathicTTP(groupA),15patientswithsecondaryTTP(groupB),2patientswithtransplantationassociatedTTP(groupC),11patientswithsuspectedTTP(groupD)and10controlhealthyvolunteers(groupE). Results MediantimesofvWFppofthefivegroupswere2.2,2.34,2.795,1.72,and1.08respectively.PlasmavWFpplevelsofthefirstfourgroupsdidn′tdiffermuchbetweeneachother(P0.05). Conclusions SignificantlyincreasedvWFpplevelinpatientswithTTPindicatesobviousendotheliuminjury.Nevertheless,itcouldnotbeusedtodifferentiateTTPtypes.

References

[1]   Levy GG, Nichols WC, Lian EC, et al. Mutations in a member of the ADAMTS gene family cause thrombotic thrombocytopenic purpura[J]. Nature, 2001, 413(6855): 488-494.
[2]   Schneppenheim R, Budde U. von Willebrand factor: the complex molecular genetics of a multidomain and multifunctional protein[J]. J Thromb Haemost, 2011, 9 (Suppl 1): 209-215.
[3]   Luken BM, Turenhout EA, Hulstein JJ, et al. The spacer domain of ADAMTS13 contains a major binding site for antibodies in patients with thrombotic thrombocytopenic purpura[J]. J Thromb Haemost, 2005, 93(2): 267-274.
[4]   Soejima K, Nakagaki T. Interplay between ADAMTS13 and von Willebrand factor in inherited and acquired thrombotic microangiopathies[J]. Semin Hematol, 2005, 42(1): 56-62.
[5]   Klaus C, Plaimauer B, Studt JD, et al. Epitope mapping of ADAMTS13 autoantibodies in acquired thrombotic thrombocytopenic purpura[J]. Blood, 2004, 103(12): 4514-4519.
[6]   Romani De Wit T, Fijnheer R, Brinkman HJ, et al. Endothelial cell activation in thrombotic thrombocytopenic purpura (TTP): a prospective analysis[J]. Br J Haematol, 2003, 123(3): 522-527.
[7]   Gadisseur A, Hermans C, Berneman Z, et al. Laboratory diagnosis and molecular classification of von Willebrand disease[J]. Acta Haematol, 2009, 121(2-3): 71-84.
[8]   Wagner DD, Fay PJ, Sporn LA, et al. Divergent fates of von Willebrand factor and its propolypeptide (von Willebrand antigen II) after secretion from endothelial cells[J]. Proc Natl Acad Sci,1987,84(7):1955-1959.
[9]   Vesely SK, George JN, Lammle B, et al. ADAMTS13 activity in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: relation to presenting features and clinical outcomes in a prospective cohort of 142 patients[J]. Blood, 2003, 102(1): 60-68.
[10]   Nangaku M, Nishi H, Fujita T. Pathogenesis and prognosis of thrombotic microangiopathy[J]. Clin Exp Nephrol, 2007, 11(2): 107-114.
[11]   Veyradier A, Obert B, Houllier A, et al. Specific von Willebrandfactor-cleaving protease in thrombotic microangiopathies: a study of 111 cases[J]. Blood, 2001, 98(6): 1765-1772.
[12]   Zheng XL, Kaufman RM, Goodnough LT, et al. Effect of plasma exchangeon plasma ADAMTS13 metalloprotease activity, inhibitor level, and clinical outcome in patients with idiopathic and nonidiopathic thrombotic thrombocytopenic purpura[J]. Blood, 2004, 103(11): 4043-4049.
[13]   Kremer Hovinga JA, Studt JD, Lammle B. The von Willebrandfactor-cleaving protease (ADAMTS-13) and the diagnosis of thrombotic thrombocytopenic purpura (TTP)[J]. Pathophysiol Haemost Thromb, 2003, 33(5-6): 417-421.
[14]   Kim JW, Kim I, Oh KH, et al. Therapeutic plasma exchange in patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: the 10-year experience of a single center[J]. Hematology, 2011, 16(2): 73-79.
[15]   Sadler JE. Von Willebrand factor, ADAMTS13, and thrombotic thrombocytopenic purpura[J]. Blood, 2008, 112(1): 11-18.
[16]   Burns ER, Zucker-Franklin D. Pathologic effects of plasma from patients with thrombotic thrombocytopenic purpura on platelets and cultured vascular endothelial cells[J]. Blood, 1982, 60(4): 1030-1037.
[17]   Lotta LA, Lombardi R, Mariani M, et al. Platelet reactive conformation and multimeric pattern of von Willebrand factor in acquired thrombotic thrombocytopenic purpura during acute disease and remission[J]. J Thromb Haemost, 2011, 9(9): 1744-1751.
[18]   韩纪举, 任道凌, 陈彬, 等. 血管性血友病因子前肽双抗体夹心法检测及临床应用[J]. 中华检验医学杂志, 2006, 29(3): 226-228.
[19]   van Mourik JA, Romani de Wit T. Von Willebrand factor pro-peptide in vascular disorders[J]. Thromb Haemost, 2001,86(1): 164-171.
[20]   Chauhan AK, Walsh MT, Zhu G, et al. The combined roles of ADAMTS13 and VWF in murine models of TTP, endotoxemia, and thrombosis[J]. Blood, 2008, 111(7): 3452-3457.
[21]   王雅丹, 魏文宁. 血栓性血小板减少性紫癜患者血管性血友病因子裂解酶活的分析[J]. 血栓与止血杂志, 2005, 11(5): 200-202.
[22]   Mori Y, Wada H, Gabazza EC, et al. Predicting response to plasma exchange in patients with thrombotic thrombocytopenic purpura with measurement of vWF-cleaving protease activity[J]. Transfusion, 2002, 42(5): 572-580.
[23]   Borchiellini A, Fijnvandraat K, ten Cate JW, et al. Quantitative analysis of von Willebrand factor propeptide release ?in vivo?: Effect of experimental endotoxemia and administration of 1-deamino-8-D-arginine vasopressin in humans[J]. Blood, 1996, 88(8): 2951-2958.
[24]   Bohm M, Betz C, Miesbach W, et al. The course of ADAMTS-13 activity and inhibitor titre in the treatment of thrombotic thrombocytopenic purpura with plasma exchange and vincristine[J]. Br J Haematol, 2005, 129(5): 644-652.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133