肺癌合并急性肺栓塞患者治疗前后血清FIB、D-D、PT和APTT水平变化及危险因素分析

The Changes of Serum FIB,D-D,PT and APTT Levels and Risk Factors in Patients with Lung Cancer Complicated with Acute Pulmonary Embolism Before and After Treatment

目的探讨肺癌合并急性肺栓塞患者治疗前后FIB、D-D、PT和APTT水平变化及危险因素分析。方法选取的晚期肺癌合并APE患者52例,所有患者在确诊后均行溶栓+抗凝治疗,根据治疗后患者预后情况分为治愈组、有效组和无效组,对比患者治疗前后及不同预后组血清FIB、D-D、PT和APTT水平,分析肺癌合并APE患者危险因素的单因素分析。结果肺癌合并APE患者治疗后血清FIB、D-D水平显著低于治疗前,血清PT和APTT水平显著高于治疗前(P<0.05);治愈组血清FIB和D-D水平显著低于显效组和无效组(P<0.05);治愈组血清PT和APTT水平显著高于显效组和无效组(P<0.05);有效组血清FIB和D-D水平显著低于无效组(P<0.05),有效组血清PT和APTT水平显著高于无效组(P<0.05);对两组年龄、肿瘤分期、基础疾病等进行统计学分析,肿瘤分期、基础疾病、化疗、手术及肿瘤转移情况具有统计学差异(P<0.05);肺癌合并APE患者预后与血清FIB和D-D水平呈负相关(γ1=-0.792,γ2=-0.815,P<0.05),肺癌合并APE患者预后与血清PT和APTT水平呈负相关(γ3=0.763,γ4=0.749,P<0.05)。结论血清FIB、D-D、PT和APTT水平与肺癌合并急性肺栓塞患者预后具有相关性,肿瘤分期、基础疾病、化疗、手术及肿瘤转移情况等因素均是影响APE发生的危险因素。

Objective To investigate the changes of FIB,D-D,PT and APTT levels and risk factors in patients with lung cancer complicated with acute pulmonary embolism before and after treatment.Methods 52 patients with advanced lung cancer merger APE were selected,all patients after diagnosis received thrombolysis and anticoagulation therapy,according to patients'prognosis can be divided into cured group,the effective and ineffective group,contrast group before and after treatment and prognosis of patients with serum,PT and APTT,FIB,D-D level,single factor analysis of patients with lung cancer merger APE risk factors analysis.Results The serum FIB and D-D levels of patients with lung cancer combined with APE were significantly lower after treatment than before treatment,and the serum PT and APTT levels were significantly higher than before treatment(P<0.05).Serum FIB and D-D levels in the cured group were significantly lower than those in the obvious group and the ineffective group(P<0.05).The serum PT and APTT levels of the cured group were significantly higher than those of the effective group and the ineffective group(P<0.05).The serum FIB and D-D levels of the effective group were significantly lower than those of the invalid group(P<0.05),and the serum PT and APTT levels of the effective group were significantly higher than those of the invalid group(P<0.05).Age,tumor stage,and basic diseases were statistically analyzed between the 2 groups,and there were statistically significant differences in tumor stage,basic diseases,chemotherapy,surgery,and tumor metastasis(P<0.05).The prognosis of patients with lung cancer combined with APE was negatively correlated with serum FIB and D-D levels(γ1=-0.792,γ2=-0.815,P<0.05),and the prognosis of patients with lung cancer combined with APE was negatively correlated with serum PT and APTT levels(γ3=0.763,γ4=0.749,P<0.05).Conclusion Serum FIB,D-D,PT and APTT levels are correlated with the prognosis of patients with lung cancer complicated with acute pulmonary embolism.Tumor stage,underlying disease,chemotherapy,surgery and tumor metastasis are all risk factors affecting the occurrence of APE.