【摘要】 目的探讨恶性肿瘤患者治疗前后血浆血栓调节蛋白(TM)、蛋白C(PC)抗原、血浆D-二聚体(D-D)含量变化及其临床意义。方法采用ELISA法检测22例急性白血病(AL)和41例实体瘤患者治疗前后血浆TM,PC抗原和D-D含量。结果AL患者化疗前血浆TM、D-D升高,PC抗原降低,与正常对照组比较有显著性差异(t=3.509~6.077,P<0.01)。缓解后,血浆TM、PC抗原均恢复至正常水平,血浆D-D含量比治疗前有明显降低(t=5.099,P<0.01),但仍高于正常水平(t=3.509,P<0.01)。实施手术的35例实体瘤患者术前血浆TM、D-D显著升高,PC抗原显著降低,与正常对照组比较均有显著性差异(t=2.586~9.000,P<0.05)。术后7d血浆D-D进一步升高,PC抗原进一步降低,TM降至正常水平。肝癌患者从Ⅰ期到Ⅲ期,血浆TM、D-D逐期升高,PC抗原逐期降低,各期间差异均有显著性。结论AL和实体瘤患者存在不同程度的血管内皮细胞损伤及凝血和纤溶系统的激活,并随病情的好转而改善,血浆TM、PC抗原、D-D含量可作为恶性肿瘤病情进展、疗效观察及预后的指标之一。更多还原

【Abstract】 ObjectiveTo study the levels of plasma thrombomodulin(TM), protein C(PC) antigen and D-Dimer(D-D) before and after treatment in acute leukemia and solid tumor patients, and to explore their clinical significance. MethodsThe levels of plasma TM, PC antigen and D-Dimer were measured by ELISA in 22 cases of leukemia and 41 solid tumors. ResultsThe plasma levels of TM and D-D increased, while PC antigen were reduced before treatment in patients with AL, compared with normal group, there was a marked significance(t=3.5096.077, P<0.01). After complete remission, TM and PC antigen returned to normal range, D-D reduced markedly but still higher than normal group(t=3.509, P<0.01). Compared with normal control group, the plasma levels of TM and D-D were elevated and PC antigen level was reduced before operation in 35 operated cases of solid tumors(t=2.5869.000, P<0.05). Seven days after operation, TM decreased to normal range, D-D increased and PC antigen decreased further. The plasma levels of TM and D-D increased gradually fromto stages in patients with hepatocarcinoma, while the PC antigen decrease gradually, there were differences between the three stages. ConclusionActivation of coagulation and fibrinolysis as well as injury of vascular endothelium existed in patients with malignant tumors, and were greatly improved with amelioration of the disease. The plasma levels of TM, PC antigen and D-D can be used as one of the indicators of the development, curative effect and prognosis of malignant tumors.更多还原