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全膝关节置换术后应用抗凝药物预防深静脉血栓的临床研究进展
Anticoagulant drugs can prevent deep vein thrombosis and related complications after total knee arthroplasty. Traditional anticoagulant drugs (unfractionated heparin, low molecular weight heparin, warfarin, etc.) take preventive effects. At present, some new oral anticoagulants (rivaroxaban, apixababan) have been widely used in clinical practice to provide patients with a safer, more convenient and effective option for the prevention of postoperative venous thrombosis. This review focuses on the advantages and disadvantages of traditional anticoagulants such as low molecular weight heparin, vitamin K antagonists, and novel oral anticoagulants rivaroxaban, apixaban. Clinical comparison of traditional anticoagulant drugs with novel oral anticoagulants is taken to provide a reference.
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抗凝血酶L99氨基酸位点突变对其功能的影响
目的 研究抗凝血酶(AT)L99氨基酸位点突变导致遗传性AT缺陷症的分子机制.方法 利用果蝇细胞表达系统表达纯化野生型AT以及L99V、L99A、L99I和L99S等突变型AT蛋白;采用肝素结合实验检测重组AT蛋白与低分子量肝素钠的结合能力;采用表面等离子共振(SPR)技术检测重组AT蛋白与凝血酶(FⅡa)及活化凝血因子X(FXa)的结合能力;将野生型及各突变型AT蛋白的浓度调整至正常AT血浆浓度后,采用发色底物法检测重组AT蛋白活性.结果 考马斯亮蓝染色及免疫印迹法显示各突变蛋白与野生型AT蛋白大小一致,未见明显杂带.肝素结合实验显示AT L99V、L99A、L99I和L99S突变蛋白与低分子量肝素钠的结合分别为相同浓度野生型AT蛋白的(44.8±3.6)％、(118.9±14.0)％、(15.2±8.8)％和(23.0±8.2)％.SPR检测显示AT L99V、L99A、L99I和L99S突变蛋白与FⅡa的结合分别为相同浓度野生型AT蛋白的13％、57％、3％和29％;AT L99V、L99A、L99I和L99S突变蛋白与FXa的结合分别为相同浓度野生型AT蛋白的7％、51％、1％和25％.发色底物法显示,野生型AT蛋白及L99V、L99A、L99I、L99S等突变型AT蛋白活性分别为146.5％、21.4％、120.9％、10.8％和39.0％.结论 L99位点突变破坏了AT与肝素、FⅡa及FXa的结合,使AT蛋白活性下降,从而导致遗传性AT缺陷症.
