摘要
目的探讨前列腺癌患者凝血和纤溶功能的变化及其临床意义。方法采用SYSMEX CA-7000全自动血凝分析仪测定104例前列腺癌患者,83例前列腺增生患者及56名健康体检者的血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)、血浆纤维蛋白原含量(Fib)和D-二聚体(D-dimer)水平,同时测定前列腺癌患者血清总前列腺特异抗原(TPSA)水平。结果前列腺癌患者的血浆Fib及D-dimer水平与正常健康体检者和前列腺增生患者相比均显著增高(P<0.05),而PT、APTT、TT水平无显著性差异(P>0.05)。血浆Fib、D-dimer水平和血清TPSA水平与前列腺癌Gleason评分有关;GS低分化癌组(Gleason8～10分)的血浆Fib及D-dimer水平均明显高于GS中高分化癌组(Gleason≤7分)(P<0.05);GS低分化癌组(Gleason8～10分)的血清TPSA水平明显高于GS高分化癌组(Gleason2～4分)(P<0.05)。前列腺癌患者血浆D-dimer水平与血清TPSA水平呈明显相关性(R=0.826,P<0.01)。前列腺增生患者的5项凝血指标与正常健康体检者之间无统计学意义(P>0.05)。结论前列腺癌患者存在一定程度的凝血和纤溶系统的激活;血浆D-dimer水平可作为前列腺癌病情诊断、病程进展、临床分期的指标之一。
Objective To explore the change and its clinical significance of blood coagulation and fibrinolysis function in patients with prostate cancer. Methods Sysmex CA - 7000 was applied to detect the plasma levels of prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT）, fibrinogen （Fib） and D - dimer in 101 patients with prostate cancer, 83 patients with prostatic hyperplasia and 56 physical examinees. The semm level of total prostate specific antigen （TPSA） was also examined in patients with prostate cancer. Results The levels of Fib and D - dimer in patients with prostate cancer were significantly higher than in patients with prostatic hyperplasia and physical examinees （P 〈 0.05）, while there were no differences of plasma PT, APTT and TT levels between patients with prostate cancer and the other two groups （P 〉 0.05）. The levels of plasma Fib, D- dimer and serum TPSA correlated with Gleason score of prostate cromer. Fib and D - dimer levels were significantly higher in high Gleason score group （Gleason 8 - 10） than those in low and median Gleason score groups （Gleason≤7）, P〈0.05. TPSA level was significantly higher in high Gleason score group （Gleason 8- 10） than that in low Gleason score group （Gleason 2 - 4）, P 〈 0.05. There was significant correlation between plasma D - dimer level and serum TPSA level in patients with prostate cancer （r = 0.826, P 〈 0.05）. There were no significant differences of the levels of blood coagulation indices between patients with prostatic hyperplasia and physical examinees （ P 〉 0.05 ）. Conclusion Activation of coagulation and fibrindytic system occurs in patients with prorate cancer to a certain degree. Plasma D- dimer can be used as an index of diagnosis, development and clinical stage of prostate cancer.
出处
《浙江预防医学》
2008年第11期7-9,共3页
Zhejiang Journal of Preventive Medicine
关键词
前列腺癌
凝血功能
D-二聚体
Prostate cancer
Blood coagulation function
D - dimer
