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目的观察晚期恶性肿瘤不伴和伴高血压患者的血管内皮损伤、凝血和纤溶指标的变化,为临床提供诊治依据。方法 2013年1月至2014年1月,入选福建医科大学附属第一医院化疗科晚期恶性肿瘤患者120例,男68例,女52例,年龄59.5(29~76)岁,根据是否合并高血压,分为晚期恶性肿瘤伴高血压组(n=60)和不伴高血压组(n=60),以同期门诊体检者60例为对照组,男38例,女22例。测定血管性血友病因子(vWF)、P-选择素、纤维蛋白原、D-二聚体的变化。结果与对照组比较,晚期恶性肿瘤不伴高血压和伴高血压组vWF[(151.3±14.7)%、(195.1±9.4)%比(113.0±10.0)%]、P-选择素[(16.4±0.9)、(19.6±0.8)比(12.0±1.0)ng/L]、纤维蛋白原[(3.6±0.2)、(5.1±0.3)比(2.8±0.3)g/L]、D-二聚体[(0.28±0.03)、(0.39±0.04)比(0.18±0.04)mg/L]明显增高;晚期恶性肿瘤伴高血压组与不伴高血压组比较,差异亦有统计学意义(均P<0.05)。相关性分析结果显示,血压与vWF(r=0.37)、P-选择素(r=0.42)、纤维蛋白原(r=0.46)和D-二聚体(r=0.39)呈正相关(均P<0.05)。结论晚期恶性肿瘤伴高血压患者的凝血和纤溶指标存在明显变化。
Objective To observe the changes of vascular endothelial injury, coagulation and fibrinolysis in patients with advanced malignancy without associated with hypertension and provide the basis for diagnosis and treatment. Methods From January 2013 to January 2014, 120 patients with advanced malignant tumors undergoing chemotherapy in the First Affiliated Hospital of Fujian Medical University were enrolled. There were 68 males and 52 females, aged 59.5 (range, 29 to 76 years). According to whether there was hypertension , Divided into advanced malignant tumor with hypertension group (n = 60) and non-hypertension group (n = 60) .On the same period, 60 outpatients were used as control group, 38 males and 22 females. Determination of von Willebrand factor (vWF), P-selectin, fibrinogen, D-dimer changes. Results Compared with the control group, the rates of vWF (151.3 ± 14.7)% and (195.1 ± 9.4)% (113.0 ± 10.0)%, P-selectin [(16.4 ± (19.6 ± 0.8) vs (12.0 ± 1.0) ng / L], fibrinogen [(3.6 ± 0.2), (5.1 ± 0.3) vs (2.8 ± 0.3) g / L] (0.28 ± 0.03), (0.39 ± 0.04) vs (0.18 ± 0.04) mg / L]. There was also a significant difference between advanced malignant tumor with hypertension group and without hypertension group (all P < 0.05). Correlation analysis showed that blood pressure was positively correlated with vWF (r = 0.37), P-selectin (r = 0.42), fibrinogen (r = 0.46) and D-dimer (r = 0.39) 0.05). Conclusion The coagulation and fibrinolysis indexes of patients with advanced malignant tumor complicated with hypertension have obvious changes.