CAJ | 학술논문

目的：研究晚期卵巢癌各中医证型的血栓前状态( PTS)指标的变化,探讨各项指标与中医分型关系。方法对84例晚期卵巢癌患者进行中医辨证分为气滞血瘀证组、气血亏虚证组、痰湿凝聚证组,分别对其采用鞘流阻抗法、免疫比浊法、ELISA法检测血小板( platelet,PLT)、D-二聚体( D-dimer,DDI)、活化部分凝血活酶时间( activated partial thromboplastin time, APTT)、血浆凝血酶原时间( prothrombin time, PT )、纤维蛋白原量( fibrinogen, FIB )、血小板α颗粒膜蛋白( granule membrane protein 140,GMP-140),并与正常组进行对比。结果(1)与正常对照组相比,晚期卵巢癌各中医证型组PLT增多(P<0.05)、PT缩短(P<0.01)、FIB升高(P<0.01)、GMP-140升高(P<0.01)及DDI升高(P<0.01),而APTT表达上无统计学差异(P>0.05)。(2)与气滞血瘀证组相比,痰湿凝聚证组PT延长(P<0.05),FIB下降(P<0.05),GMP-140下降(P<0.05),DDI下降(P<0.05),而在PLT、APTT表达上无差异(P>0.05)。与气滞血瘀证组相比,气血亏虚证组 FIB下降(P<0.05), GMP-140下降(P<0.05),DDI下降(P<0.05),而在PLT、PT、APTT表达上无差异(P>0.05)。而痰湿凝聚证组与气血亏虚证组在PLT、APTT、PT、FIB、GMP-140及DDI表达上无统计学差异( P>0.05)。(3)采用Binary Logistic回归模型分析气滞血瘀证与FIB、DDI及GMP-140有明显相关性( P<0.05)。结论晚期卵巢癌气滞血瘀证、痰湿凝聚证、气血亏虚证均存在一定程度的血栓前状态,以气滞血瘀证最为明显,DDI、FIB及GMP-140可以作为提示存在血栓前状态的晚期卵巢癌气滞血瘀证的生物学指标。检测PLT、PT、APTT、FIB、GMP-140、DDI有助于指导中医药改善晚期卵巢癌患者血栓前状态。
목적：연구만기란소암각중의증형적혈전전상태( PTS)지표적변화,탐토각항지표여중의분형관계。방법대84례만기란소암환자진행중의변증분위기체혈어증조、기혈우허증조、담습응취증조,분별대기채용초류조항법、면역비탁법、ELISA법검측혈소판( platelet,PLT)、D-이취체( D-dimer,DDI)、활화부분응혈활매시간( activated partial thromboplastin time, APTT)、혈장응혈매원시간( prothrombin time, PT )、섬유단백원량( fibrinogen, FIB )、혈소판α과립막단백( granule membrane protein 140,GMP-140),병여정상조진행대비。결과(1)여정상대조조상비,만기란소암각중의증형조PLT증다(P<0.05)、PT축단(P<0.01)、FIB승고(P<0.01)、GMP-140승고(P<0.01)급DDI승고(P<0.01),이APTT표체상무통계학차이(P>0.05)。(2)여기체혈어증조상비,담습응취증조PT연장(P<0.05),FIB하강(P<0.05),GMP-140하강(P<0.05),DDI하강(P<0.05),이재PLT、APTT표체상무차이(P>0.05)。여기체혈어증조상비,기혈우허증조 FIB하강(P<0.05), GMP-140하강(P<0.05),DDI하강(P<0.05),이재PLT、PT、APTT표체상무차이(P>0.05)。이담습응취증조여기혈우허증조재PLT、APTT、PT、FIB、GMP-140급DDI표체상무통계학차이( P>0.05)。(3)채용Binary Logistic회귀모형분석기체혈어증여FIB、DDI급GMP-140유명현상관성( P<0.05)。결론만기란소암기체혈어증、담습응취증、기혈우허증균존재일정정도적혈전전상태,이기체혈어증최위명현,DDI、FIB급GMP-140가이작위제시존재혈전전상태적만기란소암기체혈어증적생물학지표。검측PLT、PT、APTT、FIB、GMP-140、DDI유조우지도중의약개선만기란소암환자혈전전상태。
Objective To explore the relations of Prethrombotic State with TCM syndrome types of advanced ovarian cancer. Methods 84 patients with advanced ovarian cancer were divided into 3 groups according to syndrome differentiation: qi stagnation and blood stasis syndrome group, phlegm and damp condensation syndrome group and deficiency of qi and blood syndrome group. The expression of Platelet ( PLA) was tested by impedance ( PLT-I ); Activated partial thromboplastin time ( APTT ) , Fibrinogen (FIB), Prothrombin time(PT), and D-dimer(DDI)were tested by immunoturbidimetory; GMP-140 was tested by ELASA method and auto coagulometer. The results were compared to that of in the control group. Results (1)Compared to the control group, there was no significant difference on the expression of APTT in all syndrome types of advanced ovarian cancer. However, the expression of PLT(P<0. 05), FIB(P<0. 01), GMP-140(P<0. 01) and DDI (P<0. 01) were significantly higher;PT was significantly shortened (P<0. 01). (2) Compared to the qi stagnation and blood stasis syndrome group, PT was significantly longer and the level of FIB, GMP-140, DDI were significantly lower in the stagnation of phlegm and damp syndrome group(P<0. 05), while the expression of PLT and the level of APTT were no significant difference (P>0. 05). The expressions of FIB, GMP-140, DDI were significantly lower in the deficiency of qi and blood syndrome group(P<0. 05), while the expression of PLT, the level of PT and APTT were no significant difference compared to the qi stagnation and blood stasis syndrome group. (P>0. 05); There were no significant differences in the levels of PLT, PT, APTT, FIB, DDI and GMP-140 between the stagnation of phlegm and damp syndrome group and the deficiency of qi and blood syndrome(P>0. 05). (3) The qi stagnation and blood stasis syndrome group has evident correlation with the expression levels of FIB, DDI and GMP-140 ( P<0. 05 ) by Binary Logistic analysis. Conclusion Different degrees of prethrombotic state can be seen in the qi stagnation and blood stasis syndrome group, the stagnation of phlegm and damp syndrome, and the deficiency of qi and blood syndrome of advanced ovarian cancer. the most obvious changes were founded in the qi stagnation and the blood stasis syndrome group. DDI, FIB and GMP-140 can be good biological indicators as prethrombotic state of qi stagnation and blood stasis syndrome in advanced ovarian cancer. Detecting the expression levels of PLT, PT, APTT,FIB, GMP-140 and DDI can help treat thrombosis state in patients with advanced ovarian cancer.