关键字：蛋白质Z及凝血因子在恶性实体瘤患者中的变化
The Change of Protein Z and Plasma Coagulant Factors in Patients with Malignant Tumors
GUAN Zebing , PAN Xueyi, CAI Xiaoyan
(Department of Hematology，the First Affiliated Hospital of Guangdong University of Pharmacy, Guangzhou 510080,China)Abstract: Objective To study clinical significance of protein Z(PZ) in patients with malignant tumors.Methods PZ was detected with ELISA method, plasma FⅦ:C; FⅧ:C; FX:C and FⅪ:C were tested by ALC2000 fully automatic coagulantmeter in 86 patients with malignant tumors.The correlation between relapsed and unrelapsed patients was analysed.45 healthy people were as control. Results The level of PZ were remarkably lower(1 210.89 ng/ml±251.13 ng/ml vs 2 378.83 ng/ml±429.51 ng/ml,P<001). FⅦ:C. FⅧ:C, FX:C. FⅪ:C were much higher in malignant tumor group than those in control group(162.42%±36.57% vs 116.70%±28.80%,201.95%±77.54% vs 70.15%±21.28%,120.27%±7754% vs 76.13%±19.26%,145.88%±56.48% vs 77.23%±16.22%, respectively,P<0.01). The level of PZ in tumor group and control group has a significant negative correlation with level of FⅦ:C、FⅧ:C、FⅩ:C(P<0.001), PZ has no correlation with FⅪ:C (P>0.05). The level of PZ was lower and the plasma FⅦ: C, FⅧ: C, FX: C, FⅪ: C was higher in group of recurmetastatic patients than those in group of nonrecurmetastatic ones (P<0.01). Conclusion PZ was significantly lower and perhaps was a new mechanism of the acquired hypercoagulable state in patients with malignant tumor.Key words: Malignant tumors; Protein Z; FⅦ: C; FⅧ: C; FX: C; FⅪ: C
蛋白质Z(protein Z，PZ)是近年来发现的一种新的抗凝因子，为蛋白Z依赖性蛋白酶抑制性抑制凝血因子Xa的辅因子，其临床上意义正在评估。新近文献报道表明,PZ缺乏与缺血性脑卒中和急性冠脉综合征的危险性明显增加相关,但其确切机制不明。对恶性实体瘤的PZ水平至今未见报道。为此，我们对86例恶性肿瘤患者观察了PZ及其相关凝血因子Ⅶ:C、Ⅷ:C、Ⅹ:C、Ⅺ:C含量的变化，藉以探讨PZ在恶性肿瘤中的变化以及其与血栓性疾病的关系。
1 资料与方法
1.1 研究对象 恶性肿瘤组86例，男性45例，女性41例，中位年龄59.8(33～82)岁。其中肺癌组34例，肠癌组24例，乳腺癌组12例，恶性淋巴瘤组18例;复发转移组39例，未复发转移组47例。全部病例均经病理或细胞学诊断。正常对照组45例，男性25例，女性20例，
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