中晚期肝癌凝血及纤溶功能变化及其临床意义

Clinical significance and cogulation and fibrinolytic function changes in patients with advanced hepatocellular carcinoma

目的探讨中晚期肝癌凝血及纤溶功能变化及其临床意义。方法对41例中晚期原发性肝癌患者进行凝血及纤溶功能指标的检测,并与42例早期肝癌和36名健康对照组比较。结果血浆凝血酶原时间(PT)水平为中晚期肝癌组高于早期肝癌组,早期肝癌组高于对照组(P<0.01);活化的部分凝血活酶时间(APTT)水平为中晚期肝癌组低于早期肝癌组,早期肝癌组低于对照组(P<0.01);凝血酶时间(TT)水平为中晚期肝癌组与早期肝癌组比较,差异无显著性意义(P>0.05),早期肝癌组高于对照组(P<0.01);纤维蛋白原含量(FIB)水平为肝癌组低于对照组(P<0.01);各组P-选择素(Ps)、尿激酶型纤溶酶原激活物(uPA)和纤溶酶原激活物抑制物(PA1)水平为中晚期肝癌组高于早期肝癌组,早期肝癌组高于对照组(P<0.01或P<0.05);血管性血友病因子(vWF)3组比较差异无显著性意义(P>0.05)。结论中晚期肝癌患者出现凝血及纤溶功能紊乱现象,可能为评价其预后的一项敏感指标,值得进一步研究。

[Objective] To investigate coagulation and fibrinolytic function and clinical significance in patitents with advanced hepatocellular carcinoma. [Methods] Coagulation and fibrinolysis function testing were carried out in 41 patients with advanced hepatocellular carcinoma ,and the results were compared to 42 patients with early liver cancer and 36 healthy persons in control group. [Results] the level of plasma prothrombin time （PT） in advanced hepatoeellular carcinoma group was higher than that in the early HCC control group （P 〈0.01）. The level of the activated partial thromboplastin time （APTT） in advanced liver cancer group was lower than that of early HCC. There was no significance between the level of TT in advanced liver cancer group and the level in the early HHC group （P 〉0.05）, the level of TT was higher in early HCC group when compared to the control group. The FIB level in liver cancer group was lower than that in control group, the level of P-selectin （Ps）, urokinase-type plasminogen activator （uPA） and plasminogen activator inhibitor （PA1） was higher than that in Early HCC, and the level in early HCC was higher than in the heathy control group （P 〈0.01, P 〈0.05）, the level of yon WiUebrand factor （vWF） showed no significant difference （P〉0.05） in the three groups. [Conclusions] The coagulation and fibrinolysis dysfunction phenomenon in patients with advanced liver cancer may be a sensitive indicator to evaluate the prognosis and it is worth further study.