论文部分内容阅读
目的研究凝血及纤溶功能变化在原发性肝癌介入治疗中的临床意义。方法选择原发性肝癌患者189例为试验组,男111例,女78例,年龄45~86岁,平均(66.8±5.2)岁;正常对照组63例,其中男40例,女23例,年龄40~70岁,平均(55.8±6.2)岁。试验组于术前及术后检测凝血、纤溶、血常规及生化等系列指标,包括P-选择素(Ps),尿激酶型纤溶酶原激活物(uPA),血管性血友病因子(vWF),纤溶酶原激活物抑制物(PAI),活化的部分凝血活酶时间(APTT),血浆凝血酶原时间(PT),纤维蛋白原含量(Fg),凝血酶时间(TT),凝血因子Ⅶ(FⅦ),凝血因子Ⅷ(FⅧ)及凝血因子Ⅹ(FⅩ),观察凝血/纤溶功能及酸碱失衡的变化,分析可能存在的影响因素及其与凝血/纤溶功能的相关关系。结果试验组患者介入治疗前PT、APTT、TT、Ps、vWF、uPA均升高,与正常对照组比较差异有统计学意义(P<0.05);Fg、FⅦ、FⅧ、FⅩ均降低,与正常对照组比较差异有统计学意义(P<0.05)。试验组患者介入治疗后PT、APTT、TT、Pss、vWF、uPA均升高,与正常对照组比较差异有统计学意义(P<0.05);Fg、FⅦ、FⅧ、FⅩ均降低,与正常对照组比较差异有统计学意义(P<0.05)。试验组患者介入治疗后与治疗前比较,PT、APTT、TT、Ps、vWF、uPA均降低(P<0.05);FⅦ、FⅧ均升高(P<0.05)。结论原发性肝癌患者出现凝血功能障碍、纤溶功能亢进,经介入治疗后减轻,但未恢复正常,出凝血指标可能作为评价预后的敏感指标。
Objective To study the clinical significance of changes of coagulation and fibrinolysis in interventional therapy of primary liver cancer. Methods A total of 189 primary hepatocellular carcinoma patients were selected as experimental group, including 111 males and 78 females, aged 45-86 years (average 66.8 ± 5.2 years). Sixty-three normal controls (including 40 males and 23 females) Aged 40 to 70 years, mean (55.8 ± 6.2) years. The experimental group was tested before and after surgery coagulation, fibrinolysis, blood and biochemical and other indicators, including P-selectin (Ps), urokinase-type plasminogen activator (uPA), von Willebrand factor (vWF), plasminogen activator inhibitor (PAI), activated partial thromboplastin time (APTT), plasma prothrombin time (PT), fibrinogen content (Fg), thrombin time (TT) , Coagulation factor Ⅶ (F Ⅶ), coagulation factor Ⅷ (F Ⅷ) and coagulation factor Ⅹ (F Ⅹ). The changes of coagulation / fibrinolytic function and acid-base imbalance were observed. The possible influencing factors and their relationships with coagulation / fibrinolysis relationship. Results The levels of PT, APTT, TT, Ps, vWF and uPA in the experimental group were significantly higher than those in the normal control group (P <0.05). The levels of Fg, FⅦ, FⅧ, The difference between the control group was statistically significant (P <0.05). The levels of PT, APTT, TT, Pss, vWF and uPA in the experimental group were significantly higher than those in the normal control group (P <0.05). The levels of Fg, FⅦ, FⅧ and Fx in the experimental group were significantly lower than those in the normal control group The difference was statistically significant (P <0.05). Compared with before treatment, PT, APTT, TT, Ps, vWF and uPA in experimental group were significantly lower than those before treatment (P <0.05), while both FⅦ and FⅧ were increased (P <0.05). Conclusion Hepatic coagulation dysfunction, hyperfibrinolytic function in patients with primary hepatic carcinoma appear to be alleviated after interventional therapy, but not returned to normal. The coagulation index may be used as a sensitive index to evaluate prognosis.