鼻咽癌患者凝血功能变化及意义

A study on the change and clinical significance of coagulation function indexes in nasopharyngeal carcinoma

目的探讨鼻咽癌患者凝血功能指标的变化及临床意义。方法采用Sta-Compact全自动血凝分析仪测定223例鼻咽癌患者(鼻咽癌组)的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体,并与50例健康体检者(对照组)进行比较。结果鼻咽癌组患者的凝血功能指标(包括APTT、Fib、D-二聚体)的血浆水平均比对照组升高,差异有统计学意义(P<0.05);Ⅲ期和Ⅳ期的鼻咽癌患者D-二聚体水平比Ⅰ期+Ⅱ期鼻咽癌患者的D-二聚体水平明显升高,差异有统计学意义(P<0.05)。结论鼻咽癌患者PT、APTT延长以及Fib、D-二聚体升高,提示鼻咽癌患者存在凝血功能紊乱;而且Ⅲ期和Ⅳ期的鼻咽癌患者D-二聚体水平更高,提示鼻咽癌患者存在高凝状态和继发性的纤维蛋白溶解亢进。因此,凝血功能指标监测对鼻咽癌患者的治疗具有一定的指导意义。

Objective To investigate the change and clinical significance of coagulation function indexes in patients.Methods The prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer were determined in 223 patients with nasopharyngeal carcinoma and 50 normal controls.Results APTT,FIB and D-dimer in nasopharyngeal carcinoma group were significantly higher than those in normal group(P<0.05),and D-dimer in the StageⅢ-Ⅳnasopharyngeal carcinoma group was significantly higher than that in the StageⅠ-Ⅱnasopharyngeal carcinoma group(P<0.05).Conclusion Prolongation of PT and APTT,and elevation of FIB and D-dimer reveals disorder of coagulation function in patients with nasopharyngeal carcinoma.The level of D-dimer is higher in the StageⅢ-Ⅳnasopharyngeal carcinoma patients,suggesting that patients with nasopharyngeal carcinoma have hypercoagulability and secondary hyperfibrinolysis.Therefore,monitoring the coagulation indexes has certain guidance significance in the treatment of nasopharyngeal carcinoma.