【摘要】 本研究探讨淋巴瘤患者凝血功能改变的临床意义及其与国际预后指数(IPI)之间的相关性。应用磁珠法和速率法分别检测75例淋巴瘤患者和20例健康对照者的凝血4项即凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)及血清乳酸脱氢酶(LDH)水平。结果表明:①淋巴瘤患者APTT、FIB较对照组明显增高(p<0.05和<0.01),表现为高纤维蛋白原血症。不同年龄和结外病灶数之间凝血4项指标均改变不明显(p>0.05);②Ⅲ期和Ⅳ期患者APTT和FIB与Ⅱ期患者比较显著增高(p<0.05和<0.01),Ⅳ期患者FIB较Ⅲ期患者增高(p<0.05);有全身症状患者FIB显著高于无症状者(p<0.01);③LDH升高患者APTT和FIB明显高于对照组(p<0.05和<0.01),且FIB明显高于LDH正常患者(p<0.05)。体力状态(PS)2-4分患者FIB明显高于PS0-1分患者(p<0.01);④低中危、高中危和高危患者FIB明显高于对照组(p<0.01),高中危和高危患者FIB较低危患者增高(p<0.05);⑤有全身症状、LDH升高、PS2-4分、Ⅲ-Ⅳ期淋巴瘤患者FIB升高病例数与对应无症状、LDH正常、PS0-1分、Ⅱ期患者比较明显增多(p<0.05或0.01)。FIB与LDH水平、PS评分、Ann Arbor分期以及危险分级间存在正相关关系(p<0.05或0.01)。结论:淋巴瘤患者常存在高纤维蛋白原血症,受Ann Arbor分期、全身症状、LDH水平和体力状态的影响,且FIB可能是反映淋巴瘤患者预后的有关指标。更多还原

【Abstract】 The study was aimed to investigate the clinical significance of coagulation function changes in lymphoma patients and to analyze the relationship between their changes and international prognostic index (IPI). The prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT) and fibrinogen (FIB) were detected by magnetic bead method in 75 lymphoma patients and 20 healthy persons. The dehydrogenase (LDH) level was detected by rate method in all lymphoma patients and healthy persons. The results showed that (1) the APTT and FIB more obviously increased in lymphoma patients which displayed as hyperfibrinogenemia,as compared with control group (p<0.05,p<0.01); no obvious changes of coagulation indexes presented in patients with different ages and extranodal lesions (p>0.05,p<0.01). (2) APTT and FIB levels in stage Ⅲ and Ⅳ patients were much higher than those in the stage Ⅱ(p<0.05 and <0.01),and FIB level in stage Ⅳ group was significantly higher than those in the stage Ⅲ(p<0.05). FIB level in symptomatic group was significantly higher than that in asymptomatic group (p<0.01). (3) APTT and FIB in increased LDH group were obviously higher than those in control group(p<0.05,p<0.01). Furthermore,FIB in incresed LDH group was higher than that in normal LDH group(p<0.05). FIB in performance status (PS) 2-4 groups increased significantly as compared with those in PS 0-1 group(p<0.01).(4)FIB levels in the low-middle-risk,high-middle-risk and high-risk groups were significantly higher than those in control group (p<0.01),while FIB levels in high-middle-risk and high-risk groups were higher than those in low-risk group (p<0.05). (5) the number of FIB increased patients in symptomatic group,increased LDH group,PS 2-4 group and Ann Arbor stage Ⅲ-Ⅳ group were much higher than those in counterparts (p<0.05 or 0.01).There were positive correlations between FIB and LDH level,PS grades,Ann Arbor stages as well as risk grades respectively(p<0.05 or 0.01). It is concluded that lymphoma patients usually accompany with hyperfibrinogenemia which may be influenced by Ann Arbor stage,systemic symptom,LDH level and PS grade. FIB is supposed to be an effective indication of prognosis in lymphoma patients.更多还原