C反应蛋白和血小板-单核细胞聚集物检测在输血的恶性肿瘤患者中的应用

Clinical Significance of C Reactive Protein and Platelet-monocyte Aggregates Detection in Patients with Malignancy Accepted Blood Transfusion

目的观察恶性肿瘤患者输血前后C反应蛋白(C reactive protein,CRP)和血小板-单核细胞聚集物(platelet-monocyte aggregates,PMA)的变化,探讨输血的恶性肿瘤患者检测CRP和PMA的应用价值。方法分别检测41例肺癌、33例大肠癌和30例外伤后需输血患者输血前、输血后5天和输血后2周血浆超敏CRP(hs-CRP)和PMA水平,并进行统计分析。结果输血后5天,肺癌组、大肠癌组和对照组hs-CRP和PMA水平均显著高于输血前(P<0.01)。输血后2周,肺癌组、大肠癌组和对照组hs-CRP和PMA水平均显著低于输血后5天(P<0.01),但肺癌组和大肠癌组二者水平均显著高于输血前(P<0.01)。输血前后,有转移组hs-CRP和PMA水平均显著高于同期无转移组(P<0.01),输血后5天和2周,反复输血组和全血输注组hs-CRP和PMA水平均显著高于同期非反复输血组和洗涤红细胞输注组(P<0.01)。各组输血后5天hs-CRP和PMA水平显著高于输血前而输血后2周显著低于输血后5天(P<0.01),有转移组、反复输血组和全血输注组输血后2周二者水平显著高于输血前(P<0.01),无转移组、非反复输血组和洗涤红细胞输注组与输血前无显著差异(P>0.05)。结论输血与恶性肿瘤患者炎症反应和高凝状态的进展有密切关系,CRP和PMA可作为预测恶性肿瘤患者输血后病情程度的有用指标。

Objective To observe the change of C reactive protein（CRP） and platelet - monocyte aggregates（PMA） in patients with malignancy before and after blood transfusion, and to probe their clinical values in patients with malignancy. Methods Samples from 41 patients with lung cancer, 33 patients with colorectal cancer, and 30 patients with traumatic injure were detected for levels of hyper -sensitive CRP（ hs- CRP） and PMA, respectively, before, five days and two weeks after blood transfusion. And the data was analyzed with stastatical methods. Results After 5 days of blood transfusion,the levels of hs - CRP and PMA were significantly higher than those before blood transfusion at lung cancer group, eoloreetal cancer group and healthy controls group （P 〈 O. 01 ）. After 2 weeks of blood transfusion, the levels of hs - CRP and PMA in the three groups were markedly lower than those after 5 days of blood transfusion, but the levels of hs - CRP and PMA in lung cancer group and colorectal cancer group were remarkablly higher than those before blood transfusion （ P 〈 0.01 ）. Before and after blood transfusion, the levels of hs - CRP and PMA at lung cancer metastasis group were notablly higher than those at the according non - metastasis group（P 〈 0. O1 ）. After 5 days and 2 weeks of blood transfusion, the levels of hs - CRP and PMA in repeapted blood transfusion group and whole blood transfusion group were significantly higher than those in non - repeated blood transfusion group and washed red cell transfusion group（P 〈 0.01 ）. At either of the three groups, the levels of hs -CRP and PMA after 5 days of blood transfusion were remarkably higher than those before blood transfusion, but the levels of hs - CRP and PMA after 2 weeks of blood transfusion were notably lower than those after 5 days of blood transfusion（ P 〈 0.01 ）. After 2 weeks of blood transfusion, the levels of hs - CRP and PMA were markedly higher than those before blood transfusion at lung cancer metastasis group, repeated blood transfusion group and whole blood transfusion group （P 〈 0.01 ） , but in non -metastasis group, non -repeated blood transfusion group and washed red cell transfusion group,they showed less significance between before and after 2 weeks of blood transfusion（P 〉 0.05）. Conclusion Blood transfusion is closely associated with the progress of inflammation reaction and hypercoagulable state in patient with malignancy. It is valuable for CRP and PMA to predicate the disease status of patient with malignancy after blood transfusion.