不同凝血指标在胃癌患者凝血功能中的应用评价

Application assessment of different coagulation indexes in the coagulation function of gastric cancer patients

目的探讨不同时期胃癌患者凝血功能状态的差异,并比较凝血指标对胃癌患者高凝状态的检测价值。方法查阅胃癌患者的电子病历,对165例病理资料完整的新诊断胃癌患者进行回顾性研究。比较常规凝血功能指标、血小板(PLT)计数和血栓弹力图(TEG)对胃癌患者高凝状态的检测价值。结果与早期胃癌患者相比,进展期胃癌患者PLT计数、纤维蛋白原(Fib)、凝固角、最大振幅(MA)和凝血指数更大,凝血酶时间和凝血形成时间更短。MA值与PLT计数、Fib之间存在较强的线性相关关系,相关系数分别为0.534和0.525。常规凝血功能指标、PLT计数与TEG对胃癌患者高凝状态的检测结果差异有统计学意义。结论进展期胃癌患者较早期胃癌患者血液高凝状态更明显。TEG对胃癌患者高凝状态的识别能力优于常规凝血功能指标和PLT计数,但是尚不能对其完全替代,在评估胃癌患者凝血功能时应联合应用。

Objective To compare the coagulation status of patients with gastric cancer at different stages,as well as to determine the value of coagulation indexes in detecting hypercoagulability in gastric cancer patients.Methods Electronic medical records of gastric cancer patients were reviewed.A total of 165 newly diagnosed gastric cancer patients with complete pathological data were retrospectively analyzed.Compare the value of routine coagulation function indicators,platelet(PLT)count,and thromboelastogram(TEG)in detecting hypercoagulability in gastric cancer paitients.Results In this study,we found that,compared with patients who had early gastric cancer,PLT count,fibrinogen(Fib),Alpha angle,maximum amplitude(MA),and coagulation index values were larger,and thrombin time and K values were smaller in patients with advanced gastric cancer.There was a strong linear correlation between MA and PLT count/Fib,and the correlation coefficients were 0.534 and 0.525,respectively.In addition,there was a statistically significant difference between routine coagulation function indicators,PLT count,and TEG in the detection results of hypercoagulability in gastric cancer patients.Conclusion Blood hypercoagulability is more serious in patients with advanced gastric cancer than in patients with early gastric cancer.TEG is superior to the conventional coagulation function indicators and PLT count in the recognition of hypercoagulability in gastric cancer patients,but the conventional coagulation function indicators and PLT count cannot yet be substituted.Therefore,they should be combined in the evaluation of coagulation function in gastric cancer patients.