抗凝血酶Ⅲ、纤维蛋白原联合Geneva评分对肺癌患者并发肺血栓栓塞症的诊断价值

Diagnostic Value of Antithrombin Ⅲ,Fibrinogen Combined with Geneva Score in Patients with Lung Cancer Complicated with Pulmonary Thromboembolism

目的:探讨抗凝血酶Ⅲ(ATⅢ)、纤维蛋白原(FIB)联合Geneva评分对肺癌患者并发肺血栓栓塞症(PTE)的诊断价值。方法:选取2021年4月—2023年3月中国人民解放军陆军第七十三集团军医院收治的50例肺癌并发PTE患者纳入PTE组,选取同期肺癌未并发PTE的50例患者纳入对照组。收集并比较两组一般资料及血清ATⅢ、FIB水平、Geneva评分,采用logistic回归分析肺癌患者并发PTE的影响因素,应用受试者工作特征(ROC)曲线验证ATⅢ、FIB及Geneva评分对肺癌并发PTE的诊断价值。结果:PTE组冠心病、腺癌、TNM分期Ⅲ期、Ⅳ期、手术、化疗患者占比、D-二聚体、血红蛋白、ATⅢ、FIB及Geneva评分高于对照组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,ATⅢ、FIB、Geneva评分是肺癌并发PTE的独立影响因素(P<0.05)。ATⅢ、FIB、Geneva评分联合诊断的曲线下面积(AUC)为0.929,高于ATⅢ、FIB、Geneva评分单独诊断的0.776、0.783、0.771。结论:ATⅢ、FIB、Geneva评分均能很好地预测肺癌并发PTE,三者联合时诊断价值更高。

Objective:To investigate the diagnostic value of antithrombinⅢ(ATⅢ)and fibrinogen(FIB)combined with Geneva score in lung cancer patients complicated with pulmonary thromboembolism(PTE).Method:A total of 50 patients with lung cancer complicated with PTE admitted to the 73rd Army Group Hospital of the Chinese People's Liberation Army from April 2021 to March 2023 were included in the PTE group,and 50 patients with lung cancer without PTE during the same period were included in the control group.General data,serum ATⅢ,FIB levels and Geneva scores of the two groups were collected and compared.logistic regression was used to analyze the influencing factors of PTE in lung cancer patients.Receiver operating characteristics(ROC)curve was used to verify the diagnostic value of ATⅢ,FIB and Geneva scores in lung cancer patients with PTE.Result:The proportion of patients with coronary heart disease,adenocarcinoma,TNM stageⅢ,stageⅣ,surgery,chemotherapy,and D-dimer,hemoglobin,ATⅢ,FIB and Geneva scores in PTE group were higher than those in control group,and the differences were statistically significant(P<0.05).logistic regression analysis showed that ATⅢ,FIB and Geneva scores were independent influencing factors of lung cancer complicated with PTE(P<0.05).The area under the curve(AUC)of ATⅢ,FIB and Geneva combined diagnosis was 0.929,which was higher than 0.776,0.783 and 0.771 of ATⅢ,FIB and Geneva alone diagnosis.Conclusion:ATⅢ,FIB and Geneva score can well predict lung cancer complicated with PTE,and the diagnostic value of the combination of the three is higher.