恶性肿瘤血瘀证型血栓前状态分子标志物测定及其意义

目的探讨恶性肿瘤血瘀证患者血栓前状态变化和意义。方法选择恶性肿瘤患者69例,其中血瘀证组56例,非血瘀证组13例,另选33例健康人作为正常对照组。分别采用流式细胞仪、ELISA法、CLAUSS法等检测血小板膜表面糖蛋白CD41和CD62P、组织型纤溶酶原激活物（t-PA）、组织型纤溶酶原激活物抑制物-1（PAI-1）以及凝血4项指标[血浆凝血酶原时间（PT）、纤维蛋白原（Fib）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）]。结果与正常对照组比较,血瘀证组和非血瘀证组CD41表达、TT差异均无统计学意义（P〉0.05）,CD62P表达、PAI-1含量、Fib含量均升高（P〈0.01）,PT、APTT时间缩短（P〈0.01）;血瘀证组t-PA含量下降（P〈0.05）,与非血瘀证组比较,t-PA含量差异无统计学意义（P〉0.05）;与非血瘀证组比较,血瘀证组CD62P表达、Fib含量也有所升高（P〈0.05）。结论恶性肿瘤血瘀证和非血瘀证组均存在不同程度的血栓前状态,CD62P、t-PA、PAI-1、PT、Fib、APTT等的改变可能是其血栓前状态的部分物质基础。

Detection of Molecular Markers of Prethrombotic State on Blood-Stasis Syndrome of Cancer Patients and Its Clinical Significance

Objective To explore the changes and significance of prethrombotic state on blood-stasis syndrome of cancer patients.Methods Sixty-nine cancer patients were divided into blood-stasis syndrome group（56 cases） and non-blood-stasis syndrome group（13 cases）,with 33 healthy people as control group.The expression of CD41,CD62P on platelets,the level of plasma tissue plasminogen activator（t-PA）,plasminogen activator inhibitor-1（PAI-1）,activated partial thromboplastin time（APTT）,fibrinogen（Fib）,prothrombin time（PT）
prothrombin time （PT） and thrombin time （TT） of the three groups were tested by using flow cytometer, ELASA method and auto coagulometer. Results Compared with control group, there was no significant difference on the expression of platelet CD41 and TT in blood-stasis syndrome group and non-blood-stasis syndrome group （P〉0.05）, however the expression of platelet CD62P was higher （P〈0.01）, the level of plasma PAI-1 and Fib were higher （P〈0.01）, PT and APTT was shortened （P〈0.01） in blood-stasis syndrome group. The level of plasma t-PA was lower （P 〈0.05） in blood-stasis syndrome group, and there was no significant difference in non-blood-stasis syndrome group （P〉0.05）. Compared with non-blood- stasis syndrome group, the expression of platelet CD62P and the level of plasma Fib were higher （P〈0.05） in blood-stasis syndrome group. Conclusion There is a different degree of prothrombotic state in bloodstasis syndrome and non-blood-stasis syndrome of cancer patients. The changes of the expression of platelet CD62P, the level of plasma t-PA, PAI-1, PT, Fib and APTT may be the part of fundation in prethrombotic state of cancer patients.