肝癌患者测定D二聚体定量及抗凝血酶活性的临床应用研究

摘要

目的 检测不同肝功能损伤及并发癌栓的肝癌患者血浆中D二聚体(D-dimer,D-D)含量以及抗凝血酶(antithrombin,AT)活性,探讨两者在肝癌患者中的关系及临床应用.方法 采用法国Stago公司STA-R Evolution全自动血凝仪对182例肝癌(包括肝癌合并肝硬化、癌栓)患者、26例慢性肝病患者、30例健康对照者进行D-D含量以及AT活性的检测.结果 肝癌组、慢性肝病组与健康对照组比较有显著差异(P＜0.05)；慢性肝病、肝癌Ⅰ、Ⅱ期组间比较无显著差异(P＞0.05),肝癌Ⅱ、Ⅲ、Ⅳ期组间比较有显著差异(P＜0.05)；合并肝硬化代偿组与合并肝硬化失代偿组间比较有显著差异(P＜0.05),与肝癌组间比较无显著差异(P＞O.05)；合并门静脉癌栓组与肝癌无癌栓组间比较有显著差异(P＜0.05).结论 肝癌患者血浆中D-D含量及AT活性与肝功能损伤程度呈正相关.定期监测D-D及AT活性对肝癌患者癌栓形成的评估有参考价值.%Objective Detecting D-dimer ( D-D) quantitatively and antithrombin ( AT) activity of the liver cancer patients, the purpose of this research was to find the relationship of them in those liver cancer patients with different liver function injury. Methods 182 patients with hepatic cancer( including hepatic carcinoma with liver cirrhosis,carcinoma bolt) ,26 patients of chronic liver disease and 30 cases of healthy people were detected D-D quantitation and AT activity respectively using the French Stago company STA-R Evolution fully automatic blood clots meter. Results The result show statistical signification ( P < 0. 05 ) were these groups: Liver cancer, chronic liver disease group and healthy group; Liver cancer Ⅱ , Ⅲ, Ⅳ groups; Merge cirrhosis compensatory and merge decompensated liver cirrhosis groups; Complicated with portal venous tumor emboli group and liver cancer without carcinoma bolt among groups. The other groups don' t show any statistical signification( P >0.05) , including: Chronic liver disease, and liver cancer Ⅰ , Ⅱ groups, Merge cirrhosis compensatory group and liver cancer. Conclusion The quantitation of D-D and AT activity show positive relation with liver function of the liver cancer patients. This study remind that it is necessary to monitor the quantitation of D-Dand AT activity of liver cancer patients, especially the patients with carcinoma bolt formation.