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目的研究晚期神经母细胞瘤凝血象的变化。方法选取12例Ⅳ期神经母细胞瘤患儿,以凝固法测定血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB),以ELISA双抗体夹心法测定血浆D_二聚体(DD)。结果6例活动期Ⅳ期神经母细胞瘤患儿,凝血检查结果均出现异常。而5例处于静止期或完全缓解期(CR)的患儿除1例血浆DD轻度增高外,凝血检查结果均在正常范围。血浆DD为更敏感的指标,总阳性率为58.3%(7/12例),其中复发或活动期患儿85.7%(6/7例)出现异常,而处于静止期或CR期的患儿仅20.0%(1/5例)增高。结论晚期神经母细胞瘤患儿在活动期和复发期伴有明显的凝血障碍,血浆DD是检测凝血异常的敏感指标,并对了解病情严重度、临床分期及疗效观察有重要价值。
Objective To study the changes of coagulopathy in advanced neuroblastoma. Methods Twelve patients with neuroblastoma of stage Ⅳ were enrolled in this study. Plasma prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were measured by coagulation method. Plasma D-dimer (DD). Results 6 cases of active stage Ⅳ neuroblastoma in children, coagulation test results were abnormal. However, in 5 cases of children in quiescent or complete remission (CR), except one case of mild plasma DD, the results of coagulation tests were in the normal range. Plasma DD was a more sensitive marker, with a total positive rate of 58.3% (7/12 cases), of which 85.7% (6/7 cases) had recurrent or active stage abnormalities, while those in resting or CR stage only 20.0% (1/5 cases) increased. Conclusions Children with advanced neuroblastoma have obvious coagulation disorders in active stage and recurrent stage. Plasma DD is a sensitive index for detecting coagulation abnormalities. It is of great value in understanding the severity of disease, clinical staging and curative effect observation.