子宫肌瘤患者雌激素水平对凝血纤溶功能的影响及其临床意义

目的：探讨子宫肌瘤患者内源性雌激素水平对凝血纤溶功能的影响及其临床意义。方法：分别采用一期凝固法、免疫比浊法及发色底物法检测142例子宫肌瘤患者及80例正常对照组血清雌二醇（E2）、血浆凝血酶原时间（PT）、血浆活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、D-二聚体（D-D）、凝血因子Ⅷ活性（FⅧ：C）及血管性血友病因子抗原（VWF：Ag）等各项指标，并通过四分位数法将子宫肌瘤患者按雌激素水平进行分组比较分析。结果：与正常对照组比较，子宫肌瘤患者的血清E2水平、FⅧ：C及VWF：Ag含量差异无统计学意义（P＞0.05）；PT和APTT明显缩短，D-D含量升高，FIB含量降低（均P＜0.05）。按内源性雌激素水平分组，子宫肌瘤患者的Q4组PT及APTT明显短于其他3组，且Q4组D-D含量明显升高（均P＜0.05），而其他指标各组变化差异无统计学意义（均P＞0.05）。结论：子宫肌瘤患者存在相对的凝血与继发性纤溶功能增强，虽然其总体E2无明显变化，但E2水平明显升高的个体其凝血与继发性纤溶功能相对增强。

Inlfuence of estrogen level on the coagulation and ifbrinolysis in patients with hysteromyoma and its clinical signiifcance

Objective： To explore the inlfuence of endogenous estrogen level on the coagulation and ifbri-nolysis in patients with hysteromyoma and its clinical signiifcance.Methods： Serum Estradiol （E2）, prothrombin time （PT）, activated partial thromboplastin time （APTT）, ifbrinogen （FIB）, D-Dimer （D-D）, activity of factor VIII （FVIII：C） and antigen of Von Willebrand Factor （VWF：Ag） were measured by one-stage recalciifcation clotting time assay, immunoturbidimetry assay and chromogenic substrate method in 142 patients with hysteromyoma and 80 healty controls. The patients with hysteromyoma were grouped by the quartile method with their estrogen levels and comparative analysis.Results： Compared with the controls, the PT, APTT and FIB of the patients with hysteromyoma were obviously lower, but the D-Dimer was higher （respectively,P〈0.05）, and there were no sig-niifcant differences in serum E2, FVIII：C andVWF：Ag （respectively,P〉0.05）. Grouped by the endogenous estro-gen level, the PT and APTT were shorter in the Q4 group of the patients with hysteromyoma than that in the other groups, and the D-Dimer was obviously higher （respectively,P〈0.05）, but there were no signiifcant differences in the other parameters （respectively,P〉0.05）.Conclusion： The coagulation function and the secondary ifbrinolytic function in the patients of hysteromyoma can relatively enhance, though there is no signiifcant differences at the whole estradiol level in the patients of hysteromyoma, there is relatively enhancement in the coagulation and if-brinolysis in the patients of the higher estradiol level.