胃肿瘤患者4项观察指标相关性探讨

Correlative Studies on the Four Indices of the Patients with Carcinoma of Stomach

研究胃肿瘤患者舌质、血凝状态、年龄、临床病理分期四者之间的关系。方法 :140例胃肿瘤患者均经病理切片证实 ,以 10岁为一年龄段 ,病理按 TNM分类法分期 ,舌质分为紫暗舌和非紫暗舌两种 ,血凝指标有抗凝血酶 ( AT- )、血浆纤维结合蛋白 ( Fn)、纤溶总活力 ( Fa)、因子 相关抗原 ( R:Ag)。结果 :1与健康人比较 ,紫暗舌者 4项血凝指标均有非常显著的差异 ,P<0 .0 0 1,而非紫暗舌者 3项血凝指标有显著差异 ,P<0 .0 1;紫暗舌者与非紫暗舌者比较 ,2项血凝指标也有显著差异 ,P<0 .0 5。 2紫舌阳性率并不随着年龄的增加而增高 ,P>0 .0 5。 3 期患者的紫舌阳性率高达 60 % ,但 期、 期也超过 50 % ,P>0 .0 5。 4高凝状态不随着年龄的增加而加重 ,P>0 .0 5。 5临床病理分期越晚 ,高凝状态也越明显。 6各临床病理分期与各年龄段没有密切的关系 ,P>0 .0 5。结论 :舌质、血凝指标、临床病理分期与年龄没有关系 ,紫暗舌、高凝状态是胃肿瘤血瘀病机的依据 ;舌质、临床病理分期与血凝指标密切相关 ,血凝指标反应更为灵敏 ,可作为观察疾病变化的常用指标 ;舌质紫暗与否与临床病理分期无关 ,说明血瘀是胃肿瘤的病机之一 ,要根据具体情况选择适宜的治疗方法。

To study the correlations between the tongue proper,blood coagulation index,age and the pathological stages in patients with carcinoma of stomach.Methods:All the 140 cases were verified pathologically suffering carcinoma of stomach.Pathological stages were made according to the TNM classification and at the age period of 10 years and were divided into two groups based on their tongue proper:group one with dark purplish tongue proper and group two without dark purplish tongue proper.The blood coagulation indices included antothrombin-Ⅲ(AT-Ⅲ),fibronectin(Fn),total fibrinolytic activity (Fa),Factor-Ⅷ-related antigen (ⅧR-Ag)levels.Results:Significant differences were observed in the four blood coagulation indices between the cases with dark purplish tongue proper and the healthy cases(P<0.001),while in the cases without dark purplish tongue proper,there existed significant differences only in three blood coagulation indices(P< 0.01).The result also showed that the hpercoagulability was not worsened with the age,but the further the pathological stages,the more severe the hypercoagulability.No statistical difference was observed between the age and the apthological stages.Conclusions:Dark purplish tongue proper and hypercoagulability were evidences of stomach carcinoma,which could be used as indices of the pathological changes of the patients and proper therapy should be based on the correct TCM diagnosis since blood stasis was one of the causes of carcinoma of stomach.