乳腺癌患者血栓弹力图与常规凝血试验相关性分析

Analysis of correlation between TEG and conventional coagulation methods in patients with breast cancer

目的探讨乳腺癌患者血栓弹力图(TEG)各参数与常规凝血试验指标的相关性,评价2种方法在检测乳腺癌患者凝血功能中的作用。方法选取2014年在本院接受治疗的270例女性乳腺癌患者作为观察组,乳腺良性疾病患者210例作为对照组,2组均进行TEG与常规凝血试验,将TEG检测的各参数结果与凝血四项和血小板计数结果进行相关性分析,并评价TEG与常规凝血试验指标对诊断乳腺癌患者高凝状态的灵敏度和特异度。结果与乳腺良性疾病患者相比,乳腺癌患者PT(10.61±0.83)s vs(11.02±0.91)s和APTT(30.37±4.60)s vs(32.70±5.07)s,明显缩短;FIB(2.75±0.55)g/L vs(2.50±0.47)g/L及Plt(250.33±65.34)×109L-1vs(233.74±51.83)×109L-1明显升高,P均<0.05;乳腺癌组R值(3.69±0.92)min vs(4.30±1.00)min和K值(1.47±0.50)min vs(1.70±0.39)min明显缩短,Angle角(69.54±5.38)deg vs(66.55±4.37)deg、MA值(64.29±4.37)mm vs(62.24±3.58)mm和CI值(2.39±1.35)vs(1.42±1.18)明显增大,P均<0.05,表明患者存在血液高凝状态。R值与活化部分凝血活酶时间(APTT)呈正相关性,与Plt呈负相关性(P<0.05);K值与APTT、TT呈正相关性,与FIB、Plt呈负相关性(P<0.05);Angle角与APTT、TT呈负相关性,与FIB、Plt呈正相关性(P<0.05);MA与PT、APTT、TT呈负相关性,与FIB、Plt呈正相关性(P<0.05);CI与APTT、TT呈负相关,与FIB、Plt呈正相关性(P<0.05)。TEG和常规凝血试验指标对乳腺癌高凝患者的诊断灵敏度和特异性的一致性差。结论 TEG不仅能较全面地反映乳腺癌患者体内的凝血状况,而且与常规凝血试验具有相关性,二者结合能够更全面准确地反映患者的凝血状况。

Objective To investigate the relationship between TEG and conventional coagulation in patients with breast cancer, and evaluate the similarities and differences between these two methods.Methods A total of 270 patients with breast cancer who were admitted in our center from January to December 2014 were enrolled in this study. They were all females. TEG and conventional coagulation were used for detection in 270 patients with breast cancer and 210 patients with benign breast disease. The diagnostic sensitivity and specificity of both methods in these patients with hypercoagnlability were evaluated.Results Compared with patients with benign breast disease, the FIB [ （ 2. 75±0.55 ） g/L vs. （ 2. 50±0.47 ） g/L] and Plt [ （250. 33±65.34）×10^9L^-1 vs. （233.74± 51.83）×10^9L^-1] of patients with breast cancer had increased, but the PT [ （ 10. 61±0. 83） s vs. （ 11.02±0. 91 ） s] and APTT [ （30. 37±4. 60 ） s vs. （ 32. 70±5.07） s ] had decreased（ P〈0. 05） ;the alpha angel [ （69.54±5.38） deg vs. （66. 55±4. 37） deg], MA [ （64. 29±4. 37） mm vs. （62. 24±3.58） mm] and CI [ （ 2. 39± 1.35） vs. （ 1.42± 1.18） ] of breast cancer patients had increased, but the R and K had decreased （ P〈 0.05 ）. R was positively correlated with APTT and negatively correlated with Plt（P〈0. 05）.K was positively correlated with APTT and TT and was negatively correlated with FIB and Plt（ P〈0. 05）. The value of the alpha angle was negatively correlated with APTT and TT and positively correlated with FIB and Plt （P〈0. 05）.The value of MA was negatively correlated with PT, APTT and TT and positively correlated with FIB and Pit（ P〈0. 05）. CI level was significantly inversely correlated with APTT and TT, and significantly and positively correlated with FIB and Pit （P 〈0. 05）. The diagnostic sensitivity and specificity of the two methods in the patients with hypercoagulability were very different. Conclusion TEG indexes are significantly correlated with those indicators of conventional coagulation. The combination of both methods can effectively monitor the change in coagulation in patients with breast cancer.