肿瘤患者低凝状态与凝血因子活性的相关性研究

Study on the correlation between hypocoagulation state and activity of coagulation factors in tumor patients

目的 探讨肿瘤患者低凝状态与单个凝血因子活性之间的相关性。方法 回顾性分析2020年1月-12月在本院住院治疗期间,使用血栓弹力图(TEG)监测凝血功能呈低凝状态的90例肿瘤患者为实验组,根据TEG实验结果(R值、K值和Angle、MA值)分成3个实验小组,每组患者30例,同期测定凝血功能正常的30例肿瘤患者为对照组,测定所有患者凝血因子Ⅱ、Ⅴ、Ⅶ、Ⅷ、Ⅸ、Ⅹ、Ⅺ、Ⅻ和VWF的活性。结果 实验组1的R值和实验组2的K值均最高,实验组2的Angle和实验组3的MA值均最低,差异均有统计学意义(P<0. 01)。与对照组相比,实验组1 FV、FⅧ、FⅨ、FⅫ和VWF活性较低(P<0. 05);实验组2 FV、FⅦ、FⅧ和FⅫ活性较低(P<0. 01);实验组3 FⅪ、FⅫ、VWF、FⅡ、FⅩ活性较低(P<0. 05)。结论 MA值正常时,凝血因子V、Ⅷ和Ⅻ是导致肿瘤患者出现低凝状态的主要原因。MA值较低时,患者呈低凝状态常常伴随凝血因子Ⅺ、Ⅻ和VWF活性明显下降。

Objective To investigate the correlation between hypocoagulable state and activity of single coagulation factor in tumor patients.Methods A retrospective analysis was performed on 90 tumor patients with hypocoagulable blood function monitored by thrombolysis diagram(TEG)during hospitalization in our hospital from January to December 2020.According to TEG test results(R value,K value,Angle value and MA value),they were divided into three experimental groups with 30 patients in each group.30 tumor patients with normal coagulation function were collected into the control group.The activities of coagulation factorsⅡ、Ⅴ、Ⅶ、Ⅷ、Ⅸ、Ⅹ、Ⅺ、Ⅻand VWF were determined.Results The R value of experimental group 1 and K value of experimental group 2 were the highest,and the Angle value of experimental group 2 and MA value of experimental group 3 were the lowest,the differences were statistically significant(P<0.01).Compared with the control group,the activity of FV,FⅧ、FⅨ、FⅫand VWF in experimental group 1 was lower(P<0.05).The activity of FV,FⅦ、FⅧ、FⅫwas lower in experimental group 2(P<0.01).The activities of FⅪ、FⅫ、VWF、FⅡ、FX in experimental group 3 were lower(P<0.05).Conclusion When the MA value was normal,the activity of coagulation factor V,ⅧandⅫwas the main cause of hypocoagulability in tumor patients.When the MA value was low,patients with hypocoagulability were often accompanied by a significant decrease in the activity of coagulation factorsⅪ,Ⅻand VWF.