Cox比例风险模型在原发性肝癌患者凝血功能分析中的应用

Application of Cox proportional hazard model in coagulation function analysis in patients with primary liver cancer

目的应用Cox比例风险模型探讨原发性肝癌的临床分期和患者生存期与凝血功能的相关性,为临床治疗和预后提供可靠的评价指标。方法对228例原发性肝癌患者、52例普通肝病患者和52例健康对照者进行了血浆凝血功能检测,并观察肝癌分期与凝血功能的关系;进行随访并收集相关的预后资料。采用Cox比例风险模型分析凝血指标和原发性肝癌晚期患者生存期及血栓性疾病的关系。结果原发性肝癌患者凝血指标变化不仅与健康对照组的差异显著,而且随着肝癌分期程度的加重,凝血功能障碍加剧(P<0.05);D-聚体(D-dimer)、纤维蛋白原降解产物(FDP)、纤维蛋白原(FIB)和血小板(PLT)水平与晚期肝癌患者的远期生存呈负相关。结论凝血功能指标的检测能从多方面及时、准确地反映肝癌患者肝脏的损害程度及危险程度,动态地观察凝血功能指标有利于对肝癌患者的病情进行更好的监测和治疗。

Objective To explore the association of clinical staging and survival with coagulation parameters in patients with primary liver cancer by using Cox proportional hazard model so as to provide a parameter for clinical management and prognosis.Methods Coagulation parameters were evaluated in 228 patients with primary liver cancer,52 patients with common liver diseases and 52 healthy controls.The relationship between primary liver cancer staging and coagulation parameters was analyzed;follow-up examinations were performed.The Cox proportional hazard model was used to analyze the relationship between coagulation parameters and survival.Results The changes of coagulation parameters in the patients with primary liver cancer were significantly different from those in the normal controls.The effect of the disease on coagulation function became more obvious as the severity of liver cancer increased(P<0.05).The levels of D-dimer,fibrinogen degradation products(FDP),fibrinogen(FIB) and platelets(PLT) were negatively correlated with the long-term survival of patients with advanced liver cancer.Conclusion Coagulation parameters can timely and accurately reflect the lesion and risk extent in liver cancer patients.Dynamic monitoring of coagulation parameters may help ensure better surveillance and treatment for liver cancer patients.