“正常”的凝血酶生成。
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Butenas年代,凡不转向C,曼公斤
“正常”的凝血酶生成。
血。1999年10月1日,94 (7):2169 - 78。
- PubMed ID
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10498586 (在PubMed]
- 文摘
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我们调查血浆凝血因子水平变化的影响在50%和150%之间的平均值对凝血酶原,因子X,因素,因子IX因子VII,因子VIII因子V,蛋白C蛋白S、抗凝血酶III (AT-III)和组织因子途径抑制剂(TFPI)以及极端的组合,例如,50%的抗凝和促凝血的促凝血的150%或50%和150%的抗凝血剂在合成“等离子体”系统。使用净化反应系统建立了体外,自然,重组蛋白和合成磷脂囊泡或血小板反应由重组组织因子(TF)因素VIIa复杂(5 pmol / L)。调查的影响蛋白C系统,可溶性thrombomodulin (Tm)也添加到反应混合物。在最极端的情况下,必要的血浆促凝血的(第九凝血酶原,和因素X, V,和八世)和化学计量抗凝剂(AT-III和TFPI)是集体和反向改变50%,28-fold差异总的可用观察凝血酶生成。变化的这些蛋白质50%上方和下方的“正常”范围内,其余100%,只有适度影响凝血酶生成的峰值和总水平。影响凝血酶生成凝血酶原和AT-III的主导因素。这两个组件保持在100%时和所有其他等离子体促凝血的减少到50%,有60%的减少可用的凝血酶生成。没有增加时,观察凝血酶生成150%水平的血浆凝血酶原以外的促凝血的评估。当只有凝血酶原被提高到150%,其他因素都保持在100%,凝血酶生成增加了71%到121%。当AT-III在50%,其他成分都在100%,凝血酶生产增加了104%到196%。 The additions of protein C and protein S over the 50% to 150% ranges with Tm at 0.1 nmol/L concentration had limited influence on thrombin generation. Individual variations in factors VII, XI, and X concentrations had little effect on the duration of the initiation phase, the peak thrombin level achieved, or the available thrombin generated. Paradoxically, increases in factor IX concentration to 150% led to lowered thrombin generation, while decreases to 50% led to enhanced thrombin generation, most likely a consequence of factor IX as a competitive substrate with factor X for factor VIIa-TF. Reductions in factor V or factor VIII concentration led to prolongations of the initiation phase, while the reduction of TFPI to 50% led to shortening of this phase. However, none of these alterations led to significant changes in the available thrombin generated. Based on these data, one might surmise that increases in prothrombin and reductions in AT-III, within the normal range, would be potential risk factors for thrombosis and that algorithms that combine normal factor levels may be required to develop predictive tests for thrombosis.