391例实体恶性肿瘤患者凝血功能的改变及其临床意义

目的探讨不同肿瘤负荷量的恶性实体瘤患者凝血-纤溶功能的变化及其临床意义。方法将391例恶性实体肿瘤患者按肿瘤的大小分为无负荷组（110例）、轻负荷组（59例）、中负荷组（111例）、重负荷组（111例），以20例正常人作为对照组，测定血浆中Fbg，FⅧ：C、AT、D—Dimer及PLG的水平。结果肿瘤患者的Fbg、FⅧ：C、D—Dimer水平比正常人明显增高（P〈0．01），且随肿瘤负荷的增大而升高（P〈0．01）；重负荷组AT水平比无、轻、中负荷组和正常组降低（P〈0．05），无、轻、中负荷组和对照组比较无显著差异（P〉0．05）。PLG水平在各组之间无显著差异（P〉0．05）。结论恶性肿瘤患者存在不同程度的高凝状态，Fbg、FⅧ：C、D—Dimer、AT水平的异常程度与肿瘤的病情和预后有密切的关系，可作为判断病情和预后的指标；根治术后患者机体的高凝状态可能是日后复发和转移的重要原因之一。

The Change of Cruor-Fibrinolysis System in 391 Patients with Malignant Solid Tumor and its Clinical Significance

Objective To investigate the relationship of the cruor-fibrinolysis system and the tumor burden in the patients with malignant solid tumor and its clinical significance. Methods 391 patients with malignant solid tumor were divided into four groups ： group without tumor （ 110 patients）, group with small size tumor （59 patients）, group with middle size tumor （ 111 patients） and group with mass tumor （ 111 patients） according to tumor size. 20 health volunteers were served as a normal control group. The serum levels of Fbg, FⅧ ： C, AT, D- Dimer and PLG in tumor patients and health volunteers have been detected. Results The levels of Fbg, FⅧ ： C, D- Dimer in tumor patients were higher than that in health volunteers （ P 〈 0.01 ） and it was increased with the tumor size （ P 〈 0.01 ）. The level of AT in the group with mass tumor was lower than the other groups （ P 〈 0. 05 ） and there were no significant differences of the level of AT among group without tumor, group with small size tumor, group with middle size tumor and normal control group （ P 〉 0.05 ）. There were no significant differences of the level of PLG among all groups. Conclusion There were different degrees hypercoagulabale state in tumor patients. The serum levels of Fbg, FⅧ ：C, D-Dimer,AT were related to the stage and prognosis of the tumor patients. Serum levels of Fbg, FⅧ：C, D-Dimer, AT could be recognized as indicators of the condition and prognostic prediction in cancer patients. The hypercoagulabale state might be one of the factors that contributed to tumor recurrence and metastasis in patients after radical operation.