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目的:探讨低分子肝素联合瑞替普酶治疗恶性肿瘤合并下肢静脉血栓患者的疗效及对血浆凝血酶原片段1＋2(Fn 1＋2)、组织因子阳性微粒(TF＋MP)、凝血酶-抗凝血酶复合物(TAT)的影响。n 方法:选取2016年7月至2019年10月长沙市第三医院64例恶性肿瘤合并下肢静脉血栓患者进行前瞻性研究，以简单随机化法分为观察组(n n＝32)、对照组(n n＝32)。对照组予以低分子肝素治疗，观察组予以低分子肝素联合瑞替普酶治疗。比较两组疗效、临床症状改善时间、不良反应发生率、治疗前后下肢周径差、血流速度、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、血浆Fn 1＋2、TF＋MP、TAT水平，分析血浆Fn 1＋2、TF＋MP、TAT水平与临床症状改善时间、下肢周径差、血流速度、APTT、PT的相关性。n 结果:观察组总有效率(87.50%)高于对照组(65.63%)(n P<0.05)；观察组临床症状改善时间短于对照组(n P<0.05)；观察组治疗后下肢周径差低于对照组，血流速度高于对照组(n P<0.05)；观察组治疗后APTT、PT高于对照组(n P<0.05)；观察组治疗后血浆Fn 1＋2、TF＋MP、TAT水平低于对照组(n P<0.05)；血浆Fn 1＋2、TF＋MP、TAT水平与症状改善时间、下肢周径差呈正相关，与血流速度、APTT、PT呈负相关(n P0.05)。n 结论:恶性肿瘤合并下肢静脉血栓患者血浆Fn 1＋2、TF＋MP、TAT水平可作为评估患者病情及治疗效果的生物学指标，采用低分子肝素联合瑞替普酶治疗能显著降低患者血浆Fn 1＋2、TF＋MP、TAT水平，促进症状改善，有效减小下肢周径差，改善血流速度及凝血功能，疗效显著，且具有一定安全性。n “,”Objective:To investigate the changes of plasma prothrombin fragment 1+ 2 (Fn 1+2), tissue factor positive microparticle (TF+ MP) and thrombin antithrombin complex (TAT) level before and after the treatment of low molecular weight heparin combined with reteplase in patients with malignant tumor and lower extremity venous thrombosis.n Methods:From July 2016 to October 2019, 64 patients with malignant tumors and lower extremity venous thrombosis in the Third Hospital of Changsha were selected, they were divided into observation group (n n=32) and control group (n n=32) by simple randomization. The control group was treated with low molecular heparin, and the observation group was treated with low molecular heparin combined with reteplase. The efficacy, clinical symptom improvement time, incidence of adverse reactions, difference in lower limb circumference, blood flow velocity, activated partial thromboplastin time (APTT), prothrombin time (PT), plasma Fn 1+2, TF+ MP, TAT level before and after treatment were compared between the two groups; the correlations of plasma Fn 1+2, TF+ MP, and TAT level with clinical symptom improvement time, peripheral diameter difference of lower extremity, blood flow velocity, APTT, and PT were analyzed.n Results:The total effective rate of the observation group (87.50%) was higher than that of the control group (65.63%) (n P<0.05); The improvement time of clinical symptoms in the observation group was shorter than that in the control group (n P<0.05); After treatment, the peripheral limb diameter difference of the observation group was lower than that of the control group, and the blood flow velocity was higher than that of the control group (n P<0.05); The APTT and PT in the observation group were higher than those in the control group after treatment (n P<0.05); The plasma Fn 1+2, TF+ MP, and TAT level in the observation group were lower than those in the control group after treatment (n P<0.05); The levels of plasma Fn 1+2, TF+ MP, and TAT were positively correlated with symptom improvement time and lower limb circumference difference, and negatively correlated with blood flow velocity, APTT, and PT (n P0.05).n Conclusions:Plasma Fn 1+2, TF+ MP, and TAT expression in patients with malignant tumors and venous thrombosis of the lower extremity can be used as biological indicators to evaluate the patient's condition and treatment effect. Low molecular weight heparin combined with reteplase can significantly reduce the plasma Fn 1+2, TF+ MP and TAT level, promote the improvement of symptoms, effectively reduce the peripheral diameter difference of lower extremity, improve blood flow velocity and coagulation function, and has a significant effect.n