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目的新管理模式下,观察南海官兵守礁期间凝血酶原前体蛋白(protein induced vitamin K absence-Ⅱ,PIVKA-Ⅱ)和凝血功能变化,探讨守礁后期针对性干预后的效果。方法选择94名官兵为研究对象于2014/01-03月南海守礁3个月,守礁分为前期、后期各45 d,其中室内值班54人(室内组),室外站岗40人(室外组),室内组守礁期间未进行干预,室外组前期未进行干预,后期给予综合性干预,分别于上礁第3天(上礁后)、守礁中途、下礁前3天(下礁前)各取血1次,检测PIVKA-Ⅱ、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,FIB)指标,比较其变化。结果 1守礁中途、下礁前室内,室外组PIVKA-Ⅱ含量与上礁后相比差异无显著性变化(P>0.05)。2凝血分析指标:守礁中途,两组官兵FIB增高与上礁后相比有显著性差异(P<0.01),组间比较均无显著性变化(P>0.05);下礁前,室内组FIB仍然增高与上礁后有显著性差异(P<0.05),室外组经干预后,FIB降低但与上礁后比较无显著性差异(P>0.05),组间比较仅FIB有显著性差异(P<0.05)。结论目前补给、管理模式下,官兵守礁期间血液中可检出凝血酶原前体蛋白且无显著性差异,表明维生素K(vitamin K)的营养状况缺乏,但得到有效的控制;增高的纤维蛋白原经过干预后得到纠正,可防止守礁官兵血栓性疾病的发生。
Objective To observe the changes of prothrombin precursor protein (PIVKA-Ⅱ) and coagulation function in the South China Sea during the reef-keeping period of the South China Sea, and to explore the effect after targeted intervention in the late stage of defensive reef. Methods Ninety-four officers and men were selected as the study objects for 3 months in the South China Sea for reef keeping in 2014/01 - March. The defensive reefs were divided into the early stage and the late stage for 45 days, of which 54 were indoor duty (indoor group) and 40 were outdoor duty-free ), No intervention during the reef keeping in the indoor group, no intervention in the early rearing stage in the outdoor group, and comprehensive intervention at the later stage, respectively. On the 3rd day after reefing (after reefing), midway reefing and 3 days before reef (PIVKA-Ⅱ), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrin The original (fibrinogen, FIB) indicators, compare the changes. Results There was no significant difference in PIVKA-Ⅱ content before and after reefs between reefs and reefs before reefs (P> 0.05). 2 coagulation analysis indicators: midway abatement, two groups of officers and soldiers increased FIB compared with the reef after the significant difference (P <0.01), no significant changes between groups (P> 0.05); reef before the indoor group (P <0.05). The FIB in the outdoor group after intervention was lower than that in the control group (P> 0.05), and the FIB in the control group was significantly lower than that in the control group (P <0.05). Conclusions Under the current supply and management mode, there is no significant difference in the prothrombin precursor protein in the blood between officers and soldiers during defensive reefs, indicating that the nutritional status of vitamin K is deficient but effectively controlled. The increased fiber Proteins have been corrected after intervention to prevent the reef officers and men of the occurrence of thrombotic diseases.