Relationship between hypercoagulable state and erythrocyte phosphatidylserine exposure in splenectomized haemoglobin E/β-thalassaemic patients
Relationship between hypercoagulable state and erythrocyte phosphatidylserine exposure in splenectomized haemoglobin E/β-thalassaemic patients
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DOI：
10.1046/j.1365-2141.2002.03711.x
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发表时间：
2002-09-01
影响因子：
6.5
通讯作者：
Atamasirikul, K
中科院分区：
文献类型：
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作者：
Atichartakarn, V;Angchaisuksiri, P;Atamasirikul, K
血红蛋白E/β-地中海贫血（Hb E/β-thal）患者脾切除术后可发生小的肺动脉血栓形成。我们比较了15例未行脾切除术（NS）、15例已行脾切除术（S）和15例正常对照（NC）的Hb E/β-thal患者体内凝血激活的血浆标志物和促凝血活性的红细胞（RBC）标志物。S组血浆凝血酶-抗凝血酶III复合物（达特）水平显著高于NS组或NC组，S组凝血酶原片段1.2（F 1.2）水平显著高于NC组。与来自NC组的RBC相比，当将来自S组患者的RBC添加到测定中时，稀释的罗素蝰蛇毒液凝血时间显著缩短。磷脂酰丝氨酸（PS）的表达（%膜联蛋白V阳性红细胞）的红细胞膜的外叶的“大”和“小”尺寸的红细胞是显着高于NC组的S。S组和NS组RBC PS表达分别占血浆达特水平变化的25.3%（P = 0.174）和6.3%（P = 0.675）。我们的研究结果表明，当与NC相比，脾切除患者Hb E/β-地中海是在一个慢性低度高凝状态与循环PS暴露的红细胞数量增加。这种情况可能与这些患者发生肺动脉血栓形成的风险有关。
Small pulmonary arterial thromboses can occur following splenectomy of patients with haemoglobin E/beta-thalassaemia (Hb E/beta-thal). We compared plasma markers of coagulation activation in vivo and red blood cell (RBC) markers of procoagulant activity in 15 Hb E/beta-thal patients who were not splenectomized (NS), 15 who had been splenectomized (S), and 15 normal controls (NC). Levels of plasma thrombin-antithrombin III complex (TAT) were significantly higher in the S group than in either the NS or the NC groups, and levels of prothrombin fragment 1.2 (F 1.2) were significantly higher in the S than in the NC group. Diluted Russell's viper venom clotting times were significantly shorter when RBCs from group S patients were added to the assay compared with RBCs from the NC group. Phosphatidylserine (PS) expression (% of annexin V-positive RBCs) on the outer leaflet of RBC membrane of both 'larger'- and 'smaller'-sized RBCs was significantly higher for the S than the NC group. The RBC PS expression of the S and the NS groups, respectively, accounted for 25.3% (P = 0.174) and 6.3% (P = 0.675) of the variation in plasma TAT levels. Our findings indicated that, when compared with NC, splenectomized patients with Hb E/beta-thal were in a chronic low-grade hypercoagulable state associated with increased numbers of circulating PS exposed RBCs. This condition may have a role in the risk of these patients for pulmonary arterial thromboses.