蛋白C、抗凝血酶及凝血因子Ⅷ活性变化与肺癌合并肺栓塞后治疗的关系

Correlation of the activities of protein C,antithrombin and coagulation factor Ⅷ with the treatment of lung cancer with pulmonary embolism

目的探讨蛋白C（PC）、抗凝血酶（AT）及凝血因子Ⅷ（FⅧ）活性变化与肺癌合并肺血栓栓塞[简称肺栓塞（PE）]后治疗的关系.方法选择肺癌合并PE患者（肺癌＋PE组）98例及肺癌患者（肺癌组）100例.记录两组性别、年龄并检测脂蛋白（a）[Lp（a）]、总胆固醇（TC）、甘油三酯（TG）、C反应蛋白（CRP）、凝血酶时间（TT）、血小板数量（PLT）、纤维蛋白原（Fbg）等指标.检测肺癌＋PE组治疗5～7d及肺癌组入院时的PC、AT、FⅧ、D-二聚体水平.应用Logistic回归分析肺癌合并PE后治疗5～7d凝血纤溶状态的影响因素,并采用受试者工作特征（ROC）曲线分析影响因素的诊断效能.结果肺癌＋PE组Lp（a）、TC、TG、TT均明显高于肺癌组（P〈0.05）.肺癌＋PE组PC、AT、FⅧ、D-二聚体水平明显高于肺癌组（P〈0.01）.Logistic逐步回归及ROC曲线分析显示,PC、AT、FⅧ是肺癌合并PE后治疗5～7d凝血纤溶状态的影响因素,ROC曲线下面积均〉0.90.结论肺癌合并PE中期治疗需关注PC、AT、FⅧ对凝血纤溶系统的影响,其活性水平可用来评估-定时期内的治疗效果和治疗方案.

Objective To investigate the correlation of the activities of protein C(PC),antithrombin(AT)and coagulation factor Ⅷ(FⅧ)with the treatment of lung cancer with pulmonary embolism(PE).Methods A total of 98 patients with lung cancer and PE were enrolled as lung cancer with PE group.A total of 1 00 patients with lung cancer were enrolled as lung cancer group.Their sex and age were recorded,and lipoprotein(a)[Lp(a)],total cholesterol (TC),triglyceride (TG),C-reactive protein(CRP),thrombin time(TT),platelet (PLT)and fibrinogen(Fbg)in the 2 groups were determined,respectively.PC,AT,FⅧ and D-dimer were determined in lung cancer with PE group after 5-7 d of treatment.Logistic regression analysis was used to analyze the factors influencing coagulation-fibrinolysis after 5-7 d of treatment in lung cancer with PE group.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of these factors.Results Lp (a),TC,TG and TT in lung cancer with PE group were significantly higher than those in lung cancer group (P <0.05 ).The levels of PC,AT,F Ⅷ and D-dimer were significantly higher in lung cancer with PE group than those in lung cancer group (P <0.01 ).Logistic regression analysis and ROC curve analysis showed that PC,AT and FⅧ were influencing factors of coagulation-fibrinolysis after 5-7 d of treatment in lung cancer with PE group,and the areas under ROC curve were >0.90.Conclusions The influence of PC,AT and FⅧ on coagulation-fibrinolysis should be concerned in midterm treatment of lung cancer with&nbsp;PE,and their activities can be used to assess the therapeutic efficiency and treatment program in a given period.