肝脏疾病病人血浆血栓调节蛋白变化及其临床意义

目的 探讨肝脏疾病病人血浆血栓调节蛋白（TM）的变化与临床意义.方法 采用酶联免疫吸附测定（ELISA）方法,检测34例肝炎、25肝硬化、25例肝癌病人血浆TM水平,并与12例健康查体者（对照组）进行比较.结果 肝炎、肝硬化和肝癌病人血清TM水平比较,差异有显著意义（F=258.010,q=3.902～26.378,P＜0.01）,且均高于对照组,差异有显著性（q=15.782～37.026,P＜0.001）.肝硬化失代偿组TM水平高于代偿组（t′=20.628,P＜0.001）,急性重症肝炎组高于急性肝炎组（t′=23.981,P＜0.001）,肝癌术前高于术后（t′=8.348,P＜0.001）,肝癌3期TM水平比较差异有显著性（F=49.208,q=4.580～13.209,P＜0.01）.结论 TM可作为肝脏疾病病情进展及预后判断的重要指标.

THE CHANGES OF PLASMA THROMBOMODULIN AND THEIR CLINICAL SIGNIFICANCE IN PATIENTS WITH LIVER DISEASES

Objective To explore the changes of plasma thrombomodulin （TM） levels in patients with liver diseases and their significance. Methods By using ELISA, the plasma TM levels in 34 patients with hepatitis, 25 with cirrhosis, and 25 with liver cancer were measured, the results were compared with that of 12 healthy subjects. Results The differences of plasma TM levels among patients with hepatitis, cirrhosis and liver cancers were significant （F=258. 010,q=3. 902-26. 378, P=0.01）, and compared with the controls, the differences were also significant （q=15. 782-37. 026,P〈0. 001）. The levels of plasma TM in patients with decompensated cirrhosis were higher than that in patients with compensated cirrhosis （t＇=220. 628 ,P〈0. 001）, and that of acute severe hepatitis was higher than that in acute hepatitis （t＇=23. 981 ,P〈0. 001）. In cancer, TM levels were higher before surgery than after （t＇=8. 348,P〈0. 001）. A significant difference of TM was noted among three stages of the liver cancer （F=49. 208 ,q= 4. 580--13. 209 ,P〈0.01）. Conclusion The plasma TM levels might be used as an important indicator in the prediction for the development and prognosis of liver diseases.