【摘要】 目的探讨急性白血病和恶性实体肿瘤病人不同阶段血浆血栓调节蛋白(TM)、D-二聚体(D-D)变化及其临床意义。方法采用酶联免疫吸附测定(ELISA)方法,检测34例急性白血病和43例恶性实体肿瘤病人不同阶段血浆TM、D-D含量的变化,并以15例健康体检者作为对照。结果急性白血病病人化疗前血浆TM、D-D升高,与对照组比较差异有显著性(t′=2.039~5.708,P<0.05)。完全缓解后,血浆TM恢复至正常水平,血浆D-D含量较治疗前明显降低(t′=2.035,P<0.05),但仍高于对照组(t=5.681,P<0.001)。恶性实体肿瘤病人术前血浆TM、D-D显著升高,与对照组比较差异有显著性(t′=2.023~2.051,P<0.05);术前转移组二者含量明显高于未转移组(t=2.788、6.168,P<0.01);术后7 d血浆D-D值进一步升高,明显高于术前(t′=2.026,P<0.05),TM降低至正常水平。结论急性白血病和恶性实体肿瘤病人均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,血浆TM、D-D含量可作为恶性肿瘤病情进展、疗效观察及预后判定的指标之一。更多还原

【Abstract】 Objective To study the levels of plasma thrombomodulin(TM) and D-dimer(D-D) and their clinical significance in patients with acute leukemia and malignant solid tumor at different stages.MethodsPlasma TM and D-D were mea-(sured) in 34 patients with leukemia and 43 with malignant solid tumor at different stages by ELISA,and 15 healthy subjects were served as controls.ResultsCompared with the control group,the plasma TM and D-D elevated in acute leukemia before chemotherapy(t′=2.039-5.708,P<0.05);after complete remission,TM returned to normal level,but D-D was still higher than that of the control group(t′=2.035,P<0.05).In patients with malignant solid tumors,TM and D-D elevated before operation compared with the control (t′=2.023-2.051,P<0.05).The content of TM and D-D was higher in metastatic group than that of non-metastatic(t=2.788,6.168;P<0.01).Seven days after operation,TM declined to normal range,but D-D increased and higher than that of before operation(t′=2.026,P<0.05).ConclusionActivation of coagulation and fibrinolysis and injury of vascular endothelium exist in patients with malignant tumors.The plasma thrombomodulin and D-Dimer can be used as one of the indicators for assessment of the development,of therapeutic efficacy,and of the prognosis of the disease.更多还原