定期监测乳腺癌患者凝血指标对患者预后及化疗后复发的判定价值

The value of regular monitoring of coagulation parameters for prognosis and recurrence in postchemotherapeutic breast cancer patients

目的：分析定期监测乳腺癌患者凝血指标对患者预后及化疗后复发的判定价值。方法Ⅰ~Ⅲ期乳腺癌患者230例，测定患者化疗前后的凝血指标，并分析凝血指标与临床疗效和化疗后复发的关系。结果化疗后患者凝血酶时间（thrombin time，TT）和 D-二聚体（D-dimer，D-D）逐渐下降，纤维蛋白原（fibrinogen，Fib）逐渐上升，差异有统计学意义（P ﹤0.05）。化疗有效组化疗3个周期后的 D-D 显著低于无效组，差异有统计学意义（P ﹤0.05）。化疗后复发组的 D-D、凝血酶原时间国际标准化比值（prothrombin time international normalized ratio，PTINR）、血浆凝血酶原时间（prothrombin time，PT）和 Fib 均高于未复发组，差异有统计学意义（P ﹤0.01）。结论化疗可增强乳腺癌患者的凝血功能，检测凝血指标对于判断乳腺癌化疗患者临床疗效和复发具有一定的价值。

Objective To analyze the value of regular monitoring of coagulation parameters for prognosis and recurrence in post-chemotherapeutic breast cancer patients. Methods A total of 230 cases of breast cancer（stageⅠ ~ Ⅲ）were tested to determine coagulation factors in patients before and after chemotherapy. The relationship between clinical efficacy and recurrence after chemotherapy and coagula-tion indexes was analyzed. Results After chemotherapy,thromboplastin time（TT）and D-dimer（DD） decreased,while fibrinogen（Fib）gradually increased,（P ﹤ 0. 05）. After three cycles of chemotherapy, DD was significantly lower in the ineffective group（P ﹤ 0. 05）. DD,prothrombin time international nor-malized ratio（PTINR）,prothrombin time（PT）and Fib in the recurrence group were significantly higher than non-recurrence group（P ﹤ 0. 01）. Conclusion Chemotherapy can enhance coagulation in patients with breast cancer. Coagulation indexes have certain values for predicting clinical efficacy and recurrence after the chemotherapy.