化疗前后凝血指标与胃癌患者临床特征的关系

Relationship of coagulation indexes and clinical characteristics of patients with gastric cancer before and after chemotherapy

目的探讨化疗前后凝血指标与胃癌患者临床特征的关系。方法选取胃癌患者62例为研究组,选取慢性胃炎、胃溃疡患者62例为对照组。分别检测两组患者的活化部分凝血活酶时间(APTT)、血小板计数(PLT)计数、D-二聚体(D-D)、凝血酶时间(TT)、血浆纤维蛋白原(FIB)及凝血酶原时间(PT)凝血指标,比较两组患者及胃癌患者化疗前后凝血指标的变化,并对凝血指标与胃癌患者临床特征的关系进行分析。结果治疗前,研究组患者的FIB、D-D、PLT、TT、PT与对照组比较,差异均有统计学意义(P﹤0.05);治疗后,胃癌患者的PLT、FIB均低于治疗前,差异均有统计学意义(P﹤0.05);分化程度高的胃癌患者的PLT低于分化程度低的患者,TT高于分化程度低的患者,差异均有统计学意义(P﹤0.05);肿瘤发生转移胃癌患者的D-D明显高于肿瘤未发生转移的患者(P﹤0.01);临床分期高的胃癌患者的PLT、D-D、FIB、PT均高于临床分期低的患者,差异均有统计学意义(P﹤0.05);肿瘤侵袭黏膜胃癌患者的FIB低于肿瘤侵袭肌层的患者,差异有统计学意义(P﹤0.05)。结论化疗可以使胃癌患者的血液高凝加重,导致血栓形成的风险增大,值得临床给予关注。

Objective To explore the relationship between coagulation indexes and clinical characteristics of patients with gastric cancer before and after chemotherapy. Method Sixty-two patients with gastric cancer were selected as the study group, and Sixty-two patients with chronic gastritis or gastric ulcer were selected as the control group. The activated partrial thromboplastin time（APTT）, platelet（PLT） count, D-dimer（D-D）, thrombin time（TT）, plasma fibrinogen（FIB）, and prothrombin time（PT） were measured in the two groups. The changes of coagulation indexes between two groups and the changes of before and coagulation indexes before and after chemotherapy in gastric cancer patients were compare, and the relationship between coagulation indexes and clinical characteristics of gastric cancer patients analyzed.Result Before treatment, the FIB, D-D, PLT, TT and PT of patients in the study group were statistically significant different from those in the control group（P〈0.05）. After treatment, the FIB and PLT of gastric cancer patients were significantly lower than those before treatment（P〈0.05）; compared with the gastric cancer patients with low degree of differentiation, the patients with high degree of differentiation were with lower PLT and higher TT, and the difference were statistically significant（P〈0.05）; the D-D of patients with metastatic gastric cancer was significantly higher than that of patients without metastasis（P〈0.01）; the PT, FIB, PLT and D-D of gastric cancer patients with high clinical stage were significantly higher than that of patients with low clinical stage（P〈0.05）; the FIB of gastric cancer patients with tumors invade the mucosa was significantly lower than that of patients with tumors invade the muscularis（P〈0.05）. Conclusion Chemotherapy can aggravate the blood hyper-coagulation in patients with gastric cancer and increase the risk of thrombosis,which is worthy of clinical attention.