检测胃癌外周血凝血功能指标在临床中的应用价值

Clinical application value of detecting blood coagulation function index of peripheral blood in gastric cancer

目的探讨检测治疗前胃癌患者凝血功能指标的临床意义。方法选取2017年7月至2018年12月该院治疗的100例胃癌患者(胃癌组)和同期100例健康志愿者(对照组)作为研究对象。分别检测两组受检者凝血功能指标血小板(PLT)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBG)、D-二聚体、凝血因子Ⅶ活性(FⅦ:C)及凝血因子Ⅷ活性(FⅧ:C)水平。结果胃癌组血浆PLT、PT、FBG、D-二聚体、FⅦ:C及FⅧ:C水平明显高于对照组,差异有统计学意义(P<0.05)。胃癌患者临床病理分期越晚,血浆PLT、PT、FBG、D-二聚体、FⅦ:C及FⅧ:C水平越高,胃癌患者病理分期Ⅳ期各项凝血功能指标与其他病理分期比较差异有统计学意义(P<0.05);病灶直径≥5cm者血浆PLT、APTT、FBG、FⅦ:C及FⅧ:C水平明显高于病灶直径<5cm者,差异有统计学意义(P<0.05)。低分化者FⅦ:C及FⅧ:C水平明显高于中分化者、高分化者,差异有统计学意义(P<0.05);远处转移者血浆PLT、D-二聚体、FⅦ:C及FⅧ:C水平明显高于其他患者,且淋巴结转移者血浆PLT、FⅦ:C及FⅧ:C水平明显高于无转移者及脉管转移者,差异有统计学意义(P<0.05)。结论检测胃癌患者血浆凝血功能指标可有助于判断患者病情,从而为临床治疗方案制定提供参考依据,有利于改善患者预后。

Objective To explore the clinical significance of detecting coagulation function indicators in patients with gastric cancer before treatment.Methods 100 gastric cancer patients(gastric cancer group)and100 healthy volunteers(control group)treated by the hospital from July 2017 to December 2018 were selected as research objects.Platelet(PLT),prothrombin time(PT),thrombin time(TT),APTT,fibrinogen(FBG),d-dimer,coagulation factorⅦ activity(FⅦ:C)and coagulation factorⅧ activity(FⅧ:C)were measured in the two groups.Results The levels of serum PLT,PT,FBG,D-dimer,FⅦ:C and FⅧ:C in gastric cancer group were significantly higher than those in control group,the difference was statistically significant(P<0.05).The later the clinical pathological staging of gastric cancer patients,the higher the plasma levels of PLT,PT,FBG,d-dimer,FⅦ:C and FⅧ:C were,and the differences of various coagulation function indicators in stageⅣ of gastric cancer patients were statistically significant(P<0.05);Plasma PLT,APTT,FBG,FⅦ:C and FⅧ:C levels in patients with lesion diameter≥ 5 cm were significantly higher than those with lesion diameter<5 cm,with statistically significant differences(P<0.05).The levels of FⅦ:C and FⅧ:C in poorly differentiated patients were significantly higher than those in moderately differentiated and well differentiated,the difference was statistically significant(P<0.05);The levels of serum PLT,D-dimer,FⅦ:C and FⅧ:C in distant metastasis were significantly higher than other patients.The serum levels of PLT,FⅦ:C and FⅧ:C were significantly higher in patients with lymph node metastasis than those without metastasis and vascular metastasis,the difference was statistically significant(P<0.05).Conclusion Detection of serum coagulation function indicators in patients with gastric cancer can help to judge the patient′s condition,thus providing a reference for the development of clinical treatment plans,which is conducive to improving the prognosis of patients.