血浆凝血因子Ⅷ活性测定评估胃癌患者静脉血栓栓塞风险

Evaluation on the risk of venous thromboembolism in patients with gastric carcinoma by detecting the activity of plasma coagulation factor Ⅷ

目的研究血浆凝血因子Ⅷ活性测定对胃癌患者静脉血栓栓塞（VTE）风险的评估价值及其医学决定水平的确定。方法用ILACLTOP一700型血液凝固仪测定凝血因子Ⅷ活性（FⅧ：A）。用ROC评价FⅧ：A的诊断性能。采用Kaplan—Meier曲线进行生存分析。结果胃癌患者组血浆FⅧ：A（123．1±34．0％）高于健康对照组（106．8±16．7％），发生VrE胃癌患者组的FⅧ：A（184．4±47．7％）高于未发生VrE胃癌患者组（113．2±16．9％），差异均有统计学意义（P〈0．05）。不同分期患者FⅧ：A水平表现为，ⅢC期〉ⅢA期和ⅢB期〉Ⅱ期（P〈0．05），Ⅱ期与对照组间差异无统计学意义（P〉0．05）。ROC分析结果显示，血浆FⅧ：A诊断胃癌患者vrE发生的临界值为125．5％时，诊断敏感性为95．2％，诊断特异性为71．0％。血浆FⅧ：A水平高于临界值对患者在90d内的vrE累计概率显著增高（Log—rankzk45．024，P=0．000）。结论胃癌患者血浆FⅧ：A显著增高，并与病程发展相关，对vrE发生风险具有评估价值。

Objective To study the value of measuring the activity of plasma coagulation factorⅧ （FⅧ ：A） in the assessment of risk of venous thromboembolism （VTE） among patients with gastric carcinoma, and to establish the medicinal decision level. Methods IL ACL TOP - 700 blood coagulation analyzer was used to assay F Ⅷ ：A. Receiver operating characteristic curve （ROC） was employed to analyze the diagnosis performance of FⅧ ：A, and Kaplan- Meier curve was applied to implement sur- vival analysis. Results The plasma F Ⅷ ： A level was higher in gastric carcinoma patients （ 123.1 ±34.0 % ） than in the healthy controls （ 106.8 ±16.7 % ）, with statistically significant differences （P 〈 0.05）. The plasma FⅧ ： A level of gastric car- cinoma patients with VTE （ 184.4 ±47.7% ） was higher than that of gastric carcinoma patients without VTE （ 113.2 ± 16.9% ）, with statistically significant differences （P〈0.05）. The plasma FⅧ ：A levels of patients with different stages of gas- tric carcinoma showed that stage Ⅲ C 〉ⅢA and ⅢB〉 Ⅱ （P 〈 0.05）, and no statistically significant difference was found be- tween patients with stage U gastric carcinoma and the healthy controls （P〉0.05）. The result of ROC analysis showed that the optimum cut- off point with FVl ：A for VTE diagnosis in gastric carcinoma patients was 125.5 %, with the diagnosis sensitivity of 95.2% and the diagnosis specificity of 71.0%. The cumulative probability of VTE was increased significantly within 90 days in the patients with plasma FⅧ ：A level over the cut - off value （Log - rank X2 = 45. 024, P = 0. 000）. Conclusions The plasma FⅧ ：A level significantly increases in patients with gastric carcinoma, moreover, it is associated with the disease progres- sion and has predictive value in the risk assessment of VTE.