肺癌患者血浆蛋白Z及凝血因子Ⅶ检测的意义

目的观察肺癌患者凝血功能的变化，探讨肺癌患者血浆蛋白Z及凝血因子Ⅶ水平的变化及其与凝血功能、临床病理分型、分期的关系。方法选60例肺癌患者及30例健康人，采用酶联免疫吸附法检测血浆蛋白Z及凝血因子Ⅶ，采用全自动血凝分析仪测定PT、APTT、Fbg；同步检测D2聚体。结果（1）晚期肺癌组PT、APTT明显缩短（P〈0．01）．D2聚体和Fbg显著升高（P〈0．01），其中晚期小细胞肺癌患者升高更明显。（2）肺癌患者血浆中彪的浓度明显低于对照组（P〈0．01），并与肺癌的恶性程度、分期、病理分型相关。（3）肺癌患者血浆中凝血因子Ⅶ的浓度明显高于对照组（P〈0．05），并与肺癌的恶性程度、分期相关。（4）肺癌患者血浆PZ值与凝血因子Ⅶ存在负相关关系。结论（1）晚期肺癌患者多存在高凝状态，小细胞型肺癌尤为明显。（2）肺癌患者血浆中PZ的浓度明显降低，血浆中凝血因子Ⅶ的浓度明显升高。（3）肺癌患者血浆中PZ的浓度与肺癌侵袭性、恶性程度、不良预后等有密切关系。

Significance of Examining Protein Z and Coagulation Factor Ⅶ in the Blood Plasma of Patients with Lung Cancer

Objective To observe the coagulation function changes in the blood plasma of patients with lung cancer, investigate the change of level of clotting factor protein Z and Ⅶ, and discuss the relationship with the coagulation function, clinical pathological type phases of lung cancer. Methods Choose sixty patients with lung cancer and 30 healthy people. Use enzyme-linked immunosorbent mothod to test protein Z and coagulation factor Ⅶ in the blood plasma,using automated coagulation analyzer to measure the PT,APTT,Fbg and synchronous detection D2 polymer. Results （1）In the advanced lung cancer group PT and APTT reduced significantly （P〈0.01）, D2 polymer and Fbg increased significantly （P〈 0.01）, which advanced small cell lung cancer patients increased more obviously. （2）The concentration of PZ in the plasma of patients with lung cancer was significantly lower than the comparison group（P〈0.01）, and the level was related with the degree of malignancy and clinical pathological type and different phases of lung cancer. （3）The coagulation factor Ⅶ concentration in the plasma of patients with lung cancer was significantly higher than the comparison group （P〈0.05） and the level was related to the degree of malignancy and phases of lung cancer. （4）A negative correlation realationship between factor Ⅶ with coagulation factor PZ in lung cancer patients. Conclusion （1）Most of the patients with advanced lung cancer in a hypercoagulable state, small cell lung cancer is particularly evident. （2）The concentration of PZ in the plasma of patients with lung cancer significantly decreased and the concentration of coagulation factor Ⅶ significantly increased. （3）The concentration of PZ in the plasma of patients with lung cancer is closely related to invasive of lung cancer, the degree of malignancy and bad prognosis.