肝硬化和肝癌患者纤溶酶α2-抗纤溶酶复合物的检测

目的探讨肝病患者中血浆纤溶酶α2-抗纤溶酶复合物（PAP）水平及临床意义。方法采用酶联免疫吸附试验法检测71例肝病患者的血浆PAP水平，其中肝硬化25例，肝癌46例，健康对照组10例。结果肝硬化患者的血浆PAP水平为（549．60±331．67）μg／mL，肝癌患者的PAP水平为（390．56±204．12）μg／mL，都显著高于健康对照组的PAP水平（107．89±24．39）μg／mL，差异有统计学意义（P〈0．01）；肝硬化组又明显高于肝癌组，差异也有统计学意义（P〈0．05）；肝硬化分组中的酒精性肝硬化、乙型肝炎后肝硬化和其他原因的肝硬化组的PAP水平分别为（771．66±286．06）、（466．74±371．17）、（512．30±306．03）μg／mL，差异均无统计学意义（P〉0．05）；肝癌组中的初发组PAP值为（378．48±152．45）μg／mL，复发组PAP值为（388．28±273．04）μg／mL，差异也无统计学意义（P〉0．05）。观察血浆PAP与凝血指标的关系，发现PAP与凝血酶原的时间有相关性（r=0．358，P〈0．01）。结论肝病患者中血浆PAP水平的明显升高，提示患者有纤溶亢进和出血倾向，它的检测有助于临床对肝硬化、肝癌病程的观察和治疗。

Measurements of plasmin-alpha2 antiplasmin complex in patients with liver cirrohosis and hepatocarcinoma

Objective To inverstigate the level of plasmin-alpha2 antiplasmin complex （PAP） in hepatopaths and its clinical significance. Methods Enzyme linked immunosorbent assay （ELISA） was used to detect the level of PAP in 10 normal controls and 71 hepatopaths （including 25 cases of liver cirrhosis and 46 cases of hepatocarcinoma）. Results Compared with that of healthy control group（107.89±24.39）μg/mL, plasma PAP level increased obviously in cirrhosis group and hepatocarcinoma group （P〈0.01）. The PAP level was significantly higher in cirrhosis group than that in hepatocarcinoma group（549.60±331. 67）μg/mL vs （390.56±204. 12）μg/mL, P〈0.05. The plasma PAP levels （μg/mL） of alcoholic cirrhosis subgroup, posthepatitic cirrhosis subgroup and other cirrhosis subgroup were 771.66±286.06, 466.74±371.17 and 512.30±306.03, respectively, and there were no statistical differences among the subgroups （P〉0.05）. There was also no statistical difference of plasma PAP level between initial hepatocarcinoma subgroup and recurrent hepatocarcinoma subgroup （378.48±52.45 and 388.28 ± 273.04, respectively;P〉0.05）. The correlation analysis showed PAP was correlative to prothrombin time （r= 0. 358, P〈 0.01）. Conclusion The significantly elevated levels of plasma PAP in hepalopaths shows hyperfibrinolysis and bleeding tendency in the patients; measurement of PAP contributes to monitoring and treatment of liver cirrhosis and hepatocareinoma.