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[纤维蛋白肽A在外科手术中的临床意义]

[Clinical significance of fibrinopeptide A in surgery].

作者信息

Fuwa S

出版信息

Nihon Geka Gakkai Zasshi. 1984 Mar;85(3):191-205.

PMID:6236358
Abstract

Plasma Fibrinopeptide A (FPA) and beta-thromboglobulin (beta-TG) were measured in patients with various thrombogenic diseases. Plasma FPA levels were also measured in patients with malignant neoplasm and in patients who had open heart surgery. The following results were obtained. Measurement of FPA using Bentonite absorption method was simple and sensitive for clinical application. Plasma FPA and beta-TG levels were elevated in various thrombogenic diseases. Plasma FPA level correlated neither with plasma beta-TG level nor with plasma fibrinogen level. Measurement of FPA is a useful tool in the diagnosis of thromboembolic diseases, and is more trustworthy when combined with beta-TG measurement. Diagnosis of thromboembolism may be made when FPA levels are over 5 ng/ml or beta-TG over 50 ng/ml. Diagnosis of venous thrombosis was possible by the assay of FPA with a sensitivity of 100 per cent. Diagnosis of arterial thrombosis was made by the assay of beta-TG with a sensitivity of 64 per cent. In patients with gastric cancer, levels of plasma FPA tended to correlate with the size of the tumor, indicating that the progression and the activity of the tumor may be estimated by plasma FPA levels. The mean FPA level at the late stage of cardiopulmonary bypass was 14.2 +/- 6.8 ng/ml, indicating that fibrinogen is consumed during the bypass despite the systemic heparinization.

摘要

对患有各种血栓形成性疾病的患者测定了血浆纤维蛋白肽A(FPA)和β-血小板球蛋白(β-TG)。还对恶性肿瘤患者和接受心脏直视手术的患者测定了血浆FPA水平。获得了以下结果。使用膨润土吸附法测定FPA在临床应用中简单且灵敏。在各种血栓形成性疾病中,血浆FPA和β-TG水平升高。血浆FPA水平与血浆β-TG水平及血浆纤维蛋白原水平均无相关性。测定FPA是诊断血栓栓塞性疾病的有用工具,与β-TG测定联合使用时更可靠。当FPA水平超过5 ng/ml或β-TG超过50 ng/ml时,可诊断为血栓栓塞。通过测定FPA诊断静脉血栓形成的敏感性为100%。通过测定β-TG诊断动脉血栓形成的敏感性为64%。在胃癌患者中,血浆FPA水平往往与肿瘤大小相关,这表明肿瘤的进展和活性可通过血浆FPA水平来估计。体外循环后期的平均FPA水平为14.2±6.8 ng/ml,这表明尽管全身肝素化,但在体外循环期间纤维蛋白原仍被消耗。

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