非小细胞肺癌患者凝血功能及血小板异常的相关因素分析

Analysis of factors of abnormal coagulation and platelet function in patients with non-small cell lung cancer

目的探讨非小细胞肺癌(NSCLC)患者凝血功能及血小板异常的相关因素。方法选取NSCLC患者312例为观察组,同期健康体检者60例为对照组。比较两组受检者PT、国际标准化比值(INR)、APTT、TT、Fb、D-二聚体(D-dimer)、PLT、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)等指标,并分析以上指标与NSCLC患者临床特征的关系。结果观察组PT、INR、Fb、D-dimer、PLT、PCT、PDW水平均高于对照组(均P<0.05),而TT、APTT水平均低于对照组(均P<0.05)。在NSCLC患者中,男性INR、APTT水平均高于女性(均P<0.05),而TT、PLT水平均低于女性(均P<0.05);腺癌患者PT、INR、Fb水平均高于鳞癌患者(均P<0.05),而TT水平低于鳞癌患者(P<0.05);Ⅲb~Ⅳ期患者Fb、D-dimer、PLT水平均高于I~Ⅲa期患者(均P<0.05),而APTT水平低于I~Ⅲa期患者(P<0.05);有基础疾病患者的Fb、D-d ime r、PLT水平均高于无基础疾病患(均P<0.05);年龄与凝血功能及血小板参数均未见相关(均P>0.05)。结论 NSCLC患者处于血液高凝状态,其中男性、腺癌、Ⅲb~Ⅳ期及合并基础疾病的NSCLC患者血液高凝状态更明显。

Objective To analyze the factors of abnormal coagulation and platelet function in patients with non-small cell lung cancer. Methods Three hundred and twelve patients with NSCLC(NSCLC group) admitted in our hospital from January2012 to December 2015, and 60 healthy subjects(control group) were enrolled in the study. The blood coagulation parameters PT,INR, APTT, Fb, TT, D-dimer, PLT, PCT, MPV and PDW were measured in two groups. Results The PT, INR, Fb, D-dimer, PLT,PCT and PDWlevels in NSCLC patients were higher, and TT, APTT levels were lower than those in the control group(all P<0.05).The APTT and INR levels in male NSCLC patients were significantly higher, and TT and PLT levels were lower than those in female patients(all P<0.05). The Fb, PT, INR index in patients with adenocarcinoma were higher, and TT index was lower than those of patients with squamous cell carcinoma(all P<0.05). The levels of Fb, D-dimer and PLT count in stage ⅢB and Ⅳpatients were significantly higher than those in stage Ⅰand Ⅲ A patients(P<0.05). The levels of Fb, D-dimer and PLT count in NSCLC patients with comobilities significantly higher than those without comobilities(P<0.05). The coagulation parameter and platelet count was relation to age of patients(P >0.05). Conclusion NSCLC patients are in hypercoagulable state, particularly in male, adenocarcinoma, advanced NSCLC patients and those with comobilities.