磨玻璃样肺结节患者凝血功能的变化及意义

Changes and significance of coagulation function in patients with ground glass-like pulmonary nodules

目的探讨磨玻璃样肺结节(GGNs)患者的凝血、纤维蛋白溶解功能相关指标及D-二聚体的水平变化及临床意义。方法选择79例行手术切除的GGNs患者,根据病理结果分为良性结节病变16例作为GGNs良性组,恶性肿瘤病变63例作为GGNs恶性组,选取同期84例体检健康者作为健康对照组。比较各组凝血及纤维蛋白溶解功能指标,包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、纤维蛋白(原)降解产物(FDP)及D-二聚体水平。同时观察GGNs恶性组内不同病理类型凝血功能及D-二聚体水平差异。结果GGNs良性组和恶性组PT、APTT、Fib水平高于健康对照组(P<0.05),TT低于健康对照组(P<0.05)。D-二聚体及FDP水平比较,差异均无统计学意义(P>0.05)。GGNs恶性组内肿瘤不同病理类型相关指标(除D-二聚体)水平比较,差异均无统计学意义(P>0.05)。结论GGNs时期已有凝血功能紊乱的全身性变化,但早期GGNs中,病灶的良恶性质及不同病理类型凝血功能差异不明显。

Objective To investigate the changes and clinical significance of coagulation,fibrinolysis-related indicators,D-dimer levels in patients with ground glass-like pulmonary nodules(GGNs).Methods A total of 79 patients with GGNs who underwent surgical resection were selected.According to the pathological results,16 patients with benign nodular lesions were selected as benign GGNs group,63 patients with malignant tumor lesions were regarded as GGNs malignant group,and 84 healthy patients with physical examination during the same period were selected as healthy control group.The indexes of coagulation and fiibrinolysis function were compared,including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fib),fibrinogen(FDP)and D-dimer.At the same time,the differences of coagulation function and D-dimer level of different pathological types in GGNs malignant group were observed.Results The levels of PT,APTT and Fib in the benign and malignant groups of GGNs were higher than those of the healthy control group(P<0.05),and the TT was lower than that of the healthy control group(P<0.05).There was no statistically significant difference between the levels of D-dimer and FDP(P>0.05).There was no statistically significant difference in coagulation function-related indexes levels(except D-dimer)among different pathological types of tumors in the GGNs malignant group(P>0.05).Conclusion There have been systemic changes in coagulation disorder during GGNs,but in early GGNs,the difference in coagulation function between benign and malignant lesions and different pathological types are not obvious.