Nakagawa K, Tsuji H, Yamada K, Yamada Y, Masuda H, Yamagami M, Yoneda M, Takada O, Sawada S, Kitani T
Second Department of Medicine, Kyoto Prefectural University of Medicine.
Rinsho Ketsueki. 1992 Nov;33(11):1666-72.
In order to elucidate the activation of the coagulation cascade in patients with malignant neoplasms, we measured the levels of plasma prothrombin fragment F1 + 2, which is liberated in the process of thrombin generation. Twenty healthy adults (Group A), 29 patients with malignancies not complicated with DIC (Group B) and 4 patients with DIC (Group C) were evaluated. The values of F1 + 2 in Group C (2.38 +/- 0.55 nmol/l) were significantly higher (p < 0.01) than those in Group A (0.52 +/- 0.19 nmol/l) and B (0.86 +/- 0.68 nmol/l). Many patients in Group B showed higher levels of F1 + 2 compared to normal subjects, however, no significant differences were found between Group A and B. With respect to other coagulation molecular markers such as TAT, D-Dimer and PIC, F1 + 2 levels revealed positive correlation to those levels. Concerning the clinical course of DIC, elevated levels of F1 + 2 normalized much rapidly than those of TAT and D-Dimer by continuous administration of heparin. In conclusion, the measurement of plasma F1 + 2 is important in monitoring the activation of coagulation system in patients with malignancies, especially with respect to early detection and treatment of DIC.
为了阐明恶性肿瘤患者凝血级联反应的激活情况，我们检测了血浆凝血酶原片段F1 + 2的水平，该片段在凝血酶生成过程中释放。对20名健康成年人（A组）、29例未并发弥散性血管内凝血（DIC）的恶性肿瘤患者（B组）和4例DIC患者（C组）进行了评估。C组的F1 + 2值（2.38±0.55 nmol/l）显著高于A组（0.52±0.19 nmol/l）和B组（0.86±0.68 nmol/l）（p < 0.01）。与正常受试者相比，B组许多患者的F1 + 2水平较高，然而，A组和B组之间未发现显著差异。关于其他凝血分子标志物，如凝血酶 - 抗凝血酶复合物（TAT）、D - 二聚体和纤溶酶 - 抗纤溶酶复合物（PIC），F1 + 2水平与这些标志物水平呈正相关。关于DIC的临床病程，通过持续给予肝素，F1 + 2水平升高比TAT和D - 二聚体水平更快恢复正常。总之，检测血浆F1 + 2对于监测恶性肿瘤患者凝血系统的激活非常重要，特别是对于DIC的早期检测和治疗。
