CAJ | 학술논문

目的：探讨蛇毒血凝酶在肺癌根治术中的止血效果及其对凝血酶受体-1（protease-activated receptor-1，PAR-1）的影响。方法选取86例经病理证实为肺癌患者，随机分为观察组和对照组，其中对照组采用止血敏，观察组采用蛇毒血凝酶，分别在手术前后测定出血量，凝血系统相关因子，采用酶联免疫吸附实验（enzyme linked immuno sorbent assay，ELISA）测定P-选择素，流式细胞术测定血小板PAR-1，Western blot测定肺癌组织中PAR-1的表达情况，对所得数据采用统计学分析。结果观察组在术中及术后2d出血量，显著低于对照组，差异具有统计学差异（P＜0.05）；流式细胞术检测结果发现，观察组中组内不同时间段PAR-1阳性率及P-选择素无统计学意义，同对照组相比具有统计学意义（P＜0.05）；Western Blot检测发现蛇毒血凝酶对肺癌患者组织中PAR-1影响不明显，而对照组具有统计学差异义（P＜0.05）。结论蛇毒血凝酶在肺癌根治术中可以减少出血量，对凝血系统作用较为稳定，对P-选择素和PAR-1影响较小，这一结果提示蛇毒血凝酶可能在肺癌根治术患者止血过程中不会使患者出现全身血液高凝状态，即不会导致凝血酶受体高表达从而引起的肿瘤细胞转移。
목적：탐토사독혈응매재폐암근치술중적지혈효과급기대응혈매수체-1（protease-activated receptor-1，PAR-1）적영향。방법선취86례경병리증실위폐암환자，수궤분위관찰조화대조조，기중대조조채용지혈민，관찰조채용사독혈응매，분별재수술전후측정출혈량，응혈계통상관인자，채용매련면역흡부실험（enzyme linked immuno sorbent assay，ELISA）측정P-선택소，류식세포술측정혈소판PAR-1，Western blot측정폐암조직중PAR-1적표체정황，대소득수거채용통계학분석。결과관찰조재술중급술후2d출혈량，현저저우대조조，차이구유통계학차이（P＜0.05）；류식세포술검측결과발현，관찰조중조내불동시간단PAR-1양성솔급P-선택소무통계학의의，동대조조상비구유통계학의의（P＜0.05）；Western Blot검측발현사독혈응매대폐암환자조직중PAR-1영향불명현，이대조조구유통계학차이의（P＜0.05）。결론사독혈응매재폐암근치술중가이감소출혈량，대응혈계통작용교위은정，대P-선택소화PAR-1영향교소，저일결과제시사독혈응매가능재폐암근치술환자지혈과정중불회사환자출현전신혈액고응상태，즉불회도치응혈매수체고표체종이인기적종류세포전이。
Objective To investigate hemocoagulase hemostatic effect in lung cancer radical surgery and its effect on protease-activated receptor-1 (PAR-1 ).Methods 86 cases of pathologically confirmed lung cancer patients were randomly divided into control group and observation group,which controls were used etamsylate,observation group were used hemocoagulase,then to measure the amount of bleeding,clotting system-related factors before and after surgery,using ELISA assay to detect P-selectin,flow cytometry to measure platelet PAR-1 ,Western Blot to determine lung tissue expression of PAR-1,and the resulting data were statistically analyzed. Results The blood loss of observation group during surgery and postoperative 2d compared with the control group,had a significant difference (P<0.05 );flow cytometry results showed that,PAR-1-positive rate and P-selectin in different time periods in observation group were no statistically significant,while had a statistically significant compared with control group(P<0.05 );Western Blot detected hemocoagulase of lung tissue in patients with PAR-1 had no obvious effect,while control group had significant difference (P<0.05).Conclusion Venin hemocoagulase in lung cancer radical surgery can reduce the amount of bleeding,and be more stable for the role of the coagulation system,as well as less effect on the P-selectin and PAR-1.The results suggest that vonin hemocoagulase might not make patients with systemic hypercoagulable state in patients undergoing radical process with lung cancer,in other words it might not lead to PAR-1 highly expression to cause tumor cell metastasis.