蛋白质Z及凝血因子在恶性实体瘤患者中的变化

目的研究蛋白质Z（protein Z,PZ）在恶性肿瘤患者中的变化,并探讨其临床意义。方法对86例恶性肿瘤患者的PZ、FⅦ：C、FⅧ：C、FX：C、FⅪ：C进行测定。PZ用ELISA法,血浆FⅦ：C、FⅧ：C、FⅩ：C、FⅪ：C用一期法与ACL-2000全自动凝血仪进行测定。45名健康人作为对照。同时对复发转移组与未复发转移组作分析比较。结果恶性肿瘤组的PZ水平（1210．89ng/ml±251．13ng/ml）明显下降（对照组为2378．83ng/ml±429．51ng/ml）,FⅦ：C、FⅧ：C、FⅩ：C、FⅪ：C水平明显升高,分别为162．42%±36．57%、201．95%±77．54%、120．27%±77．54%、145．88%±56．48%（对照组分别为116．70%±28．80%、70．15%±21．28%、76．13%±19．26%、77．23%±16．22%）,P值均＜0．01。相关研究中,发现恶性肿瘤组及对照组中的PZ水平与FⅦ：C、FⅧ：C、FⅩ：C水平之间均存在明显负相关（P值均＜0．001）,而PZ与FⅪ：C无相关性（P＞0．05）。对肿瘤的病情研究发现,复发转移组PZ、FⅦ：C、FⅧ：C、FⅩ：C、FⅪ：C与未复发转移组比较,转移组的PZ更低,FⅦ：C、FⅧ：C、FX：C、FⅪ：C水平更高（P＜0．01）。结论PZ水平在恶性肿瘤患者中明显减低,且与病情有关。PZ与FⅦ：C、FⅧ：C、FX：C存在明显负相关。提示PZ缺乏可能是恶性肿瘤患者获得性易栓症的一个新的发病因素。

The Change of Protein Z and Plasma Coagulant Factors in Patients with Malignant Tumors

Objective To study clinical significance of protein Z （PZ） in patients with malignant tumors. Methods PZ was detected with ELISA method, plasma FⅦ：C; FⅧ：C ;FⅩ：C and FⅪ：C were tested by ALC-2000 fully automatic coagulant-meter in 86 patients with malignant tumors. The correlation between relapsed and un-relapsed patients was analysed. 45 healthy people were as control. Results The level of PZ were remarkably lower（ 1 210.89 ng/ml ± 251. 13 ng/ml vs 2 378.83 ng/ml ± 429.51 ng/ml, P 〈 0. 01）. FⅦ：C. FⅧ：C, FⅩ： C. F Ⅺ：C were much higher in malignant tumor group than those in control group（ 162.42%±36.57% vs 116.70% ±28.80% ,201.95% ±77.54% vs 70.15% ±21.28% ,120.27% ±77.54% vs 76.13% ± 19.26% ,145.88% ±56.48% vs 77.23% ± 16.22%, respectively,P 〈0.01）. The level of PZ in tumor group and control group has a significant negative correlation with level of F Ⅶ ： C, FⅧ：C,FⅩ：C（P 〈0.001 ） , PZ has no correlation with FⅪ：C （P 〉0.05）. The level of PZ was lower and the plasma FⅦ： C, FⅧ： C, FⅩ： C, FⅪ： C was higher in group of recurmetastatic patients than those in group of non-recur-metastatic ones （ P 〈 0.01 ）. Conclusion PZ was significantly lower and perhaps was a new mechanism of the acquired hypercoagulable state in patients with malignant tumor.