肺癌患者凝血功能相关指标变化及其临床意义

Coagulation related parameters in patients with lung cancer detection

目的了解肺癌患者凝血指标和血栓弹力图(TEG)的变化并探讨其临床意义。方法选取河北省涿州市医院80例肺癌患者为肺癌组,40例健康人为正常对照组,分别测定各组凝血指标和TEG,比较各组间的差异,并分析其与肺癌病情变化的关系。结果肺癌组TEG指标反应时间(R)、凝固时间(K)、最大振幅(MA)、血小板弹性指标(E值)明显升高,凝血指标纤维蛋白原(FIB)、血浆D-二聚体(D-Dimer)与正常对照组比较升高显著,差异均有统计学意义(P<0.05),而凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血活酶时间(TT)比较,差异无统计学意义(P>0.05);鳞癌组、腺癌组和小细胞未分化癌组之间TEG与凝血指标比较,差异均无统计学意义(P>0.05);在肺癌的不同病理分期中,Ⅲ-Ⅳ期的R、K值明显短于Ⅰ-Ⅱ期(P<0.05),而MA、E值明显宽于Ⅰ-Ⅱ期(P<0.05),且FIB、D-Dimer水平明显高于Ⅰ-Ⅱ期(P<0.05)。结论凝血指标和TEG的检测可对肺癌患者的凝血状态进行动态观察,在判断肺癌患者病情进展、预后中有一定的参考价值。

Objective To investigate the coagulation markers and thrombelastograph（TEG） of lung cancer patients and the relationship between its change and clinical significance. Methods Eighty lung cancer patients and forty healthy people form zhuozhou hospital were enrolled as lung cancer group and control group. The Helliger and SYSMAX CA-1500 were used to detect coagulation markers and TEG. Compare all the parameters between lung cancer patients and healthy people. All the parameters during development of lung cancer were also compared. Results The parameters（R、K、MA、E） of TEG and coagulation markers（FIB、D-Dimer） showed significant difference between lung cancer patients and healthy control（p〈0.05）. No significant difference was found in PT,APTT or TT（p〈0.05）. No significant difference was found in neither TEG nor coagulation markers by pathological types of lung cancer（p〈0.05）. Based on the pathological stage,the level of R、K of Ⅲ-Ⅳ stage was significantly less than that of Ⅰ-Ⅱstage（p〈0.05）. And the level of MA、E、FIB、D-Dimer ofⅢ-Ⅳ stage was significantly higher than that ofⅠ-Ⅱstage（p〈0.05）.Conclusion The detection of coagulation markers and TEG can dynamically monitorcoagulation status of lung cancer patients. It provides some reference value for predicting the progression and prognosis of lung cancer.