Effects of Xuezhikang Capsule(血脂康胶囊) on Blood Lipids,Platelet Activation and Coagulation-Fibrinolysis Activity in Patients with Hyperlipidemia

Objective: To investigate the effects of Xuezhikang capsule (XZK,血脂康胶囊) on blood lipids level, platelet activation and coagulation-fibrinolysis activity in patients with hyerlipidemia. Methods: Seventy-six patients of hyperlipidemia were randomly divided into two groups, the XZK group (n=38) treated with XZK 600mg, taken two times per day and the Simvastatin (SIM) group (n = 38) treated with SIM 20mg per day, with the treatment lasting 8 weeks for both groups. Levels of fasting serum lipids, including total cholesterol (TC), triglyceride (TG), high and low density lipoprotein cholesterol (HDL-C and LDL-C), plasma GMP-140, fibrinogen (FIB), tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-) and prothrombin time (PT) were all measured before and 8 weeks after treatment. Data were compared before and after treatment and also compared with those measured in 20 healthy subjects of control. Results: Before treantment the levels of TC, TG and LDL-C were obviously higher and HDL-C level was significantly lower in hyperlipidemia patients than those in healthy subjects (P<0.05 or P<0.01). After 4-8 weeks of XZK treatment, the levels of TC, TG, LDL-C and FIB and activities of GMP-140 and PAI-1 were obviously lowered (P<0. 05 or P<0. 01). But in the SIM group there was no obvious change in FIB (P>0.05), instead it showed obvious increase of HDL-C and decrease of TC and LDL-C after treatment (P<0.05 or P<0.01). Conclusion: XZK could inhibit platelet activity and improve coagulation-fibrinolysis function, besides its lipids lowering effect.

A Comparison Study of the Effects Injectable Contraceptive Cyclofem on Blood Coagulation and Fibrinolysis

Forty-six healthy women received Cyclofem (25mg medroxyprogesterone acetate with sing estradiol cypionate) and other /orly--five women, as control,received oral contraceptive pill (Ortho--Novum 1/35, containing norethisterone enantate ling and estradiol valerate 35fig) for nine months. Blood samples were taken during the follicular and luteal phases o/preu treatment, and for Cyclofem group, immediately prior to the 3rd and gth injections and 1 and 3 weeks a/ter the 3rd and gth injections, for Ortho Novum group, blood samples were taken on the irst day o[.the 3rd and gth pill cycles and 1 and 3 weeks later in both cycles. For both groups after at least 3 months nonhormonal method of contraception, blood sampling was repeated at follicular and luteal phases of a normal mentrual cycle.Coagulation and librinolysis parameter were detected including hemoglobin,platelet count, prothrombin time, APTT, fibrinogen, factor Vll, [actor X,plasminogen, in PAl, AT Ill (functional and immunological assays) and protein C.In the Cyclolem group, hemoglobin, platelet count, fibrinogen and /Octor X were not changed. Factor Vll significantly reduced. Prothrombin time and APTT showed minor changes. Plasminogen and protein C decreased while t-- PAl and AT 11.1 increased. These changes showed a dynamic balance between coagulatioll and fibrinolysis. In Ortho---Novum 1/35 group, platelet count, jactor X and [ibrinogen increased and prothrombin time and APTT accelerated. In fibrinolysis and anticoagulation system, plasminogen increased as well as protein C, but AT Ill declined. Those changes showed a tendency o[ hyper-coagulabllity state, fibrinolysis and anticoagulation were enhanced to a certain extent.The result of our study is that there are slight 'changes on coagulation and [ibrinolyls is in Cyclofem injectable contraceptive users.

Detection and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy

Objective:To investigate the changes and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy.Methods:Review the clinical data of threatened abortion in early pregnancy (include continuing pregnancy and miscarriages) and healthy pregnant women in the early pregnancy in our hospital, and the levels of reproductive hormones, prethrombotic state markers and coagulation related factors were compared between the three groups.Results: The results of single factor variance showed that the levels ofβ-HCG, progesterone, E2, PC, PLG, D-D, TAT, F1+2 and PAI-1 level were all statistically significant. Compared with the control group, the average levels ofβ-HCG, progesterone, E2 and PLG in the pregnancy maintenance group and the interrupted pregnancy group were significantly decreased, and the level of the interrupted pregnancy group was significantly lower than that of the pregnancy maintenance group. The levels of PC, D-D, TAT, F1+2 and PAI-1 in the pregnancy maintenance group and the interrupted pregnancy group were significantly higher than those in the control group, and the level of the interrupted pregnancy group was significantly higher than that of the pregnancy maintenance group. There was no significant difference in the level of AT III between the groups.Conclusion: There are significant abnormal levels of reproductive hormones, prethrombotic state markers and coagulation related factors in patients with threatened abortion in early pregnancy, the detection of its index level is of great value in predicting threatened abortion in the early stage.

Effects of laparoscopic and open surgery on serum tumor markers, coagulation function and immune function in patients with early endometrial cancer

Objective: To investigate the effects of laparoscopic surgery and open surgery on serum tumor markers, coagulation function and immune function in patients with early endometrial cancer. Methods: The clinical data of 82 cases of early endometrial carcinoma were retrospectively analyzed, and they were divided into control group (n=40) and observation group (n=42) according to the treatment plan. Patients in the control group were treated with open surgery, and the observation group received laparoscopic treatment. The levels of serum tumor markers, coagulation function and immune function indexes of the two groups were compared between before operation and 1 d after operation. Results: The levels of serum CA-125, HE4, PT, APTT, FIB, CD3+, CD4+, CD8+ and CD4+/CD8+in the two groups before treatment were not significantly different. After treatment, the levels of CA-125, HE4, PT, APTT, CD3+, CD4+and CD4+/CD8+ in the two groups were significantly lower than those before treatment in the same group, and the levels of CA-125, HE4, PT and APTT in the observation group were significantly lower than those in the control group, the levels of CD3+, CD4+ and CD4+/CD8+ in the observation group were significantly higher than those of the control group;After treatment, the levels of FIB in the two groups were significantly higher than that before treatment, and the level of observation group was significantly higher than that of the control group. Conclusion: Compared with open surgery for early endometrial cancer, laparoscopic surgery can effectively reduce the level of serum tumor markers and the inhibition of immune function, however, it has great influence on coagulation function, and effective measures should be taken to prevent the formation of thrombotic diseases.

Effects of DC-CIK cell immunotherapy combined with chemotherapy on immune function, coagulation function and tumor stem cell markers in patients with recurrent ovarian cancer

Objective: To investigate the effects of immunotherapy with dendritic cells (DC)-cytokine induced killer cells (CIK) combined with chemotherapy on immune function, coagulation function and tumor stem cell markers in patients with recurrent ovarian cancer. Methods: A total of 80 cases in our hospital for treatment of recurrent ovarian cancer patients were selected as the research object, they were divided into chemotherapy group (n=35) and combined treatment group (n=45) according to whether or not to receive cellular immunotherapy, chemotherapy group received TC chemotherapy, combined therapy group were given DC-CIK cell immunotherapy combined with TC chemotherapy group, the two groups were treated with 21 d for a cycle, 3 cycles were treated;The changes of immune function, coagulation function and tumor stem cell markers were compared between the day of blood collection and the end of treatment for 7 d. Results: After the end of treatment for 7 d, the CD3+, CD3+CD4+, CD4+/CD8+, NK cell number of combined treatment group were significantly higher than that of blood collection day, the number of CD4+ CD25+ was significantly lower than that of blood collection day, The improvement of peripheral blood T lymphocyte subsets in the combined treatment group was better than that in the chemotherapy group;After the end of treatment for 7 d, the FIB levels of two groups were significantly decreased than those of the blood collection day, the difference was statistically significant;After the end of treatment for 7 d, the CD133 and DDX4 levels of two groups were significantly lower than that of the blood collection day, and the combined treatment group was significantly lower than the chemotherapy group, the difference were statistically significant. Results: DC-CIK cell immunotherapy combined with chemotherapy can significantly improve the immunity and the level of FIB of patients with recurrent ovarian cancer, and regulating the level of serum tumor stem cell markers in patients, it has positive significance to improve the prognosis of patients, and is worthy of popularization and application in clinic.

Clinical association between coagulation indicators and bone metastasis in patients with gastric cancer

BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.

Percutaneous microwave ablation and transcatheter arterial chemoembolization for serum tumor markers and prognostics of middle-late primary hepatic carcinoma

BACKGROUND Primary hepatic carcinoma(PHC)has an insidious onset and is usually diagnosed in the middle and late stages.Although transcatheter arterial chemoembolization(TACE)is the preferred option for treating middle-and advanced-stage PHC,it has limited efficacy in killing tumor cells and poor long-term efficacy.TACE plus percutaneous microwave coagulation therapy(PMCT)is more effective than interventional therapy alone and can improve survival time.However,there are few reports on the effects of TACE and PMCT on serum marker levels and the prognosis of patients with advanced PHC.AIM To investigate the effect of PMCT+TACE on serum tumor markers and the prognosis of middle-late PHC.METHODS This retrospective study included 150 patients with middle-late PHC admitted to Zhongshan People’s Hospital between March 2018 and February 2021.Patients were divided into a single group(treated with TACE,n=75)and a combined group(treated with TACE+PMCT,n=75).Before and after treatment,the clinical efficacy and serum tumor marker levels[carbohydrate antigen 19-9(CA19-9),alpha-fetoprotein(AFP),and carcinoembryonic antigen(CEA)]of both groups were observed.The 1-year survival rates and prognostic factors of the two groups were analyzed.RESULTS The combined group had 21 and 35 cases of complete remission(CR)and partial remission(PR),respectively.The single group had 13 and 25 cases of CR and PR,decreased,with the decrease in the combined group being more significant(P<0.05).The 1-year survival rate of the combined group(80.00%)was higher than that of the single group(60.00%)(P<0.05).The average survival time within 1 year in the combined group was 299.38±61.13 d,longer than that in the single group(214.41±72.97 d,P<0.05).COX analysis revealed that tumor diameter,tumor number,and the treatment method were prognostic factors for patients with middle-late PHC(P<0.05).CONCLUSION TACE+PMCT is effective in treating patients with mid-late PHC.It reduces the levels of tumor markers,prolongs survival,and improves prognosis.

Aspects of the Molecular Markers of Hemostatic Mechanism in Qinical Medicine

Thrombosis is the pathological process resulting from the inappropriate and propagation of the hemostatic response. The principle determinants of thrombosis can be categorized in contemporary terms according to Virchow' s paradigm: abnormalities in endothelial function ( vessel function ), rheotogy ( blood flow ), or blood component,either alone or in combination, can promote thrombus formation.

Analysis on the therapeutic effects of integrated traditional Chinese and Western medicine on ulcerative colitis and its effects on coagulation function and inflammatory factors

Objective:To analyze the therapeutic effects of Integrated Traditional Chinese and Western Medicine on ulcerative colitis (UC) and its effects on coagulation function and inflammatory factors.Methods: 220 cases of patients with UC were selected as the research subjects and randomly divided into the observation group and the control group, 110 cases were included into each group. The patients in the control group were treated with single western medicine, while the patients in the observation group were treated with enema treatment of traditional Chinese Medicine. The clinical therapeutic effects of the two groups were evaluated and compared. The blood coagulation indexes of the activated partial thromboplastin time (APTT), prothrombin time (PT), the plasma fibrinogen (Fib), the D dimer (D-D) of two groups patients who in the treatment were detected and compared. The serum tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) levels of the patients in the two groups were measured and compared.Results: The clinical efficiencies of the observation group and the control group were 97% and 75%, the clinical efficiencies and the therapeutic effects of the observation group were better than those in the control group, there were statistically significant differences between the two groups. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The plasma Fib levels and the plasma D-D levels after the treatment of the patients in the observation group were lower than those in the control group, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the two groups were significantly lower than those before the treatment, the difference was statistically significant. The serum inflammatory factors levels after the treatment of the patients in the observation group were lower than those in the control group, the difference is powerful and have statistically significant.Conclusion: The application of Integrated Traditional Chinese and Western Medicine in the treatment of UC can improve the therapeutic effect significantly, correct imbalance of the patients' coagulation dissolution function, reduce the degree of inflammatory reaction, which benefits to promote of the patients' rehabilitation, reduce the incidence of complications and improve the prognosis of patients.

Effect of massive blood transfusion on blood coagulation function and fibrinolytic system in patients with acute trauman

Objective:To investigate the effect of a large number of blood transfusion on coagulation function and fibrinolytic system in patients with acute trauma.Methods:A total of 86 cases of traumatic blood transfusion emergency and hospitalized patients during January 2014 to January 2016 in our hospital, divided into two groups according to the early blood transfusion, acute trauma patients need a lot of blood transfusion for the observation group (47 cases), trauma patients need a small amount of blood transfusion as the control group (39 cases). Statistical analysis and comparison of two groups patients of four blood coagulation [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FIB)], platelet count (PLT), protein C (PC) and fiber soluble system index [D dimer (D-D), fibrin degradation products (FDP) levels before and after blood transfusion of 1 d, 5 d'. Results:Before blood transfusion, there was no significant difference between the two groups. There was no significant difference in the level of the observed indexes in the control group before and after transfusion. 1 d after blood transfusion, compared with blood transfusion before and the control group at the same time , the observation group PT[(18.4±4.3) s], APTT[(42.9±7) s], TT[(21.4±4.8) s] were significantly prolonged, D-D[(282.2±115) g/L] and FDP[(6.3±2.1) mg/L] were significantly increased, and FIB[(2.9±1.3) g/L], PLT[(72.5±34.4) 109] and PC[(2.4±1.2) mg/L] levels were significantly decreased. 5 d after blood transfusion, compared with blood transfusion before and the control group at the same time ,the observation indexes showed no significant difference;5 D after blood transfusion compared with 1 D, the observation group PT[(14.8±1.7) s], APTT[(34.7±5.4) s], TT[(14.7±2.5) s] was significantly shortened, D-D[(151.8±62.4) g/L] and FDP[(3.7±1.2) mg/L] were significantly decreased, FIB[(3.7±0.8) g/L], PLT[(179±70.8) 109] and PC[(3.9±1.5) mg/L] levels were significantly higher.Conclusion:Large amount of blood transfusion has great influence on the coagulation function and fibrinolysis system in acute trauma patients. It is necessary to monitor coagulation status in time and avoid complications such as coagulation dysfunction, so as to improve the success rate of implementation of massive transfusion regimen.

Effect of urokinase thrombolysis on the cardiac function, coagulation, and fibrinolytic system in patients with AMI

Objective:To observe the effect of urokinase thrombolysis on the cardiac function, coagulation, and fibrinolytic system in patients with acute myocardial infarction (AMI). Methods: A total of 39 patients with AMI who were admitted in our hospital from March, 2016 to November, 2016 were included in the study and served as the observation group. The peripheral venous blood before and after thrombolysis was collected. The plasma NT-proBNP level, related coagulation factors, and fibrinolysis indicators were detected. The cardiac function before treatment was evaluated. A total of 30 healthy individuals who came for physical examinations were served as the control group for contrastive analysis.Results:The plasma NT-proBNP, Fg, and D-D levels before thrombolysis in the observation group were significantly higher than those in the control group, while PT, APTT, and TT in the observation group were significantly shortened. The plasma NT-proBNP and D-D levels 2-48 h after thrombolysis in the observation group were significantly elevated first and reduced later and reached the peak 4 h after treatment, while PT, APTT, and TT were significantly extended first and shortened later. The plasma Fg level was significantly reduced first and elevated later and reached the minimum 4 h after treatment. During the treatment process, in the observation group, 2 had mucocutaneous hemorrhage, 3 had nasal hemorrhage, and 1 had gingival bleeding, but no gastrointestinal bleeding or cerebral hemorrhage occurred.Conclusions:The thrombolytic therapy can effectively reduce the coagulation activity in patients with AMI, strengthen the fibrinolysis activity, and improve the cardiac function.

肺腺鳞癌患者预后影响因素分析

目的:探讨肺腺鳞癌(ASC)患者预后影响因素并建立列线图模型。方法:回顾性分析2009年1月-2020年1月沧州市中心医院ASC患者临床资料。Kaplan-Meier法进行单因素分析,生存差异采用Log-Rank检验,COX回归分析筛选ASC癌患者预后独立影响因子,评价其生存差异和建立模型。结果:149例患者总mOS为17.7个月。多因素分析结果显示手术、化疗、联合治疗、瘤周有炎症变化、脑转移是预后的独立影响因子。亚组分析结果显示,手术组mOS高于未手术组(P<0.001);化疗组mOS高于未化疗组(P=0.005);联合治疗组mOS高于未联合治疗组(P=0.002),瘤周无炎症变化组mOS高于瘤周有炎症变化组(P=0.013),脑转移组mOS低于无脑转移组(P<0.001),高风险组(≥3分)mOS高于低风险组(<3分)(P=0.054)。基于上述5个因子构建的列线图模型预测患者生存的准确度为0.752(AUC=0.752,95%CI:0.659~0.845),模型预测患者生存率与实际生存率的一致性较高。结论:ASC整体预后差。瘤周炎症变化、脑转移、手术、化疗、联合治疗是ASC预后的独立影响因子,基于此建立的预测模型可辅助ASC患者临床诊疗与预后判断。

肿瘤标志物联合血常规炎性指标、凝血功能指标在上皮性卵巢癌诊断中的价值分析

目的从肿瘤标志物、血常规炎性指标和凝血功能指标中寻找辅助上皮性卵巢癌诊断的血液学指标组合。方法选取2021年5月至2023年5月郑州大学第三附属医院收治的118例上皮性卵巢癌患者为上皮性卵巢癌组,117例卵巢良性肿瘤患者为卵巢良性肿瘤组。检测和比较2组间血液学检验指标的差异,包括肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、CA15-3、CA125和人附睾蛋白4(HE4),血常规炎性指标血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞和单核细胞比值(LMR)和红细胞分布宽度(RDW),凝血功能指标凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)和D-二聚体。选取组间差异有统计学意义的指标通过多因素Logistics回归分析筛选出上皮性卵巢癌的独立危险因素。通过受试者工作曲线(ROC)分析单一指标检测对上皮性卵巢癌的诊断效能。通过二元Logistics回归分析联合ROC曲线分析多指标联合检测对上皮性卵巢癌的诊断效能。结果肿瘤标志物CA15-3、CA125和HE4,血常规炎性指标PLR、NLR和LMR以及凝血功能指标FIB和D-二聚体的表达在上皮性卵巢癌组和卵巢良性肿瘤组之间存在差异,差异具有统计学意义(P<0.05)。多因素分析结果显示CA125、HE4、FIB和D-二聚体是上皮性卵巢癌的独立危险因子(OR>1)。ROC曲线分析结果显示,CA125、HE4、LMR、FIB和D-二聚体对上皮性卵巢癌诊断的AUC分别为0.911、0.933、0.768、0.801和0.872。7种多指标联合检测中,CA125+HE4+LMR+FIB+D-二聚体诊断上皮性卵巢癌的AUC最大,为0.986,灵敏度为96.6%,特异性为96.6%。结论术前血液肿瘤标志联合血常规炎性指标、凝血功能指标的多指标联合检测可以作为上皮性卵巢癌鉴别诊断的一种辅助方法,可为临床提供更有价值的诊断信息。

补肾通脉方对急性ST段抬高型心肌梗死PCI术后凝血-纤溶系统及血脂的影响

目的:观察补肾通脉方对急性ST段抬高型心肌梗死经皮冠状动脉介入术(PCI)术后凝血-纤溶系统及血脂的影响。方法:选取2017年3月—2020年3月南京中医药大学附属徐州中医院收治的92例急性ST段抬高型心肌梗死患者,按照随机分组的方法,将其分为对照组和治疗组,各46例。入组患者均给予标准化内科治疗,治疗组在标准治疗的基础上加用补肾通脉方。观察两组治疗前后纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物(t-PA)、纤溶酶原活化物抑制剂1(PAI-1)、可溶性白细胞分化抗原40配体(sCD40L)、可溶性细胞间黏附因子-1(sICAM-1)及血脂的变化。结果:治疗前,两组FIB、AT-Ⅲ、t-PA、PAI-1水平比较,差异无统计学意义(P>0.05);治疗后,两组FIB、PAI-1水平下降,AT-Ⅲ、t-PA水平升高,治疗组FIB、PAI-1水平低于对照组,AT-Ⅲ、t-PA水平高于对照组,差异有统计学意义(P<0.05)。治疗前,两组sCD40L、sICAM-1水平比较,差异无统计学意义(P>0.05);治疗后,两组sCD40L、sICAM-1水平均显著下降,治疗组sCD40L、sICAM-1水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05);治疗后,两组TC、TG、LDL-C水平均显著下降,HDL-C升高,治疗组TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05)。结论:在标准化内科治疗基础上加用补肾通脉方能够改善急性ST段抬高型心肌梗死患者PCI术后高凝状态,调节患者体内凝血-纤溶系统平衡,控制炎症反应,降低血脂水平。

重组人血管内皮抑制素注射液联合GP化疗方案治疗晚期NSCLC的可行性

目的观察重组人血管内皮抑制素注射液联合GP化疗方案治疗晚期非小细胞肺癌(NSCLC)的可行性。方法回顾性选取2020年5月—2022年12月皖北煤电集团总医院肿瘤内科收治的晚期NSCLC患者80例,将采用GP化疗方案治疗者纳入GP化疗组(n=40),重组人血管内皮抑制素注射液联合GP化疗方案治疗者纳入联合用药组(n=40),2组均以3周为1个治疗周期,共治疗2个周期。比较2组患者近期疗效,用药前后实验室指标、生活质量评分,不良反应及1年存活率。结果联合用药组客观缓解率为85.00%,高于GP化疗组的52.50%(χ^(2)=9.833,P=0.002)。用药2个周期后,2组血清癌胚抗原、糖类抗原125水平低于用药前,凝血酶时间、活化部分凝血活酶时间短于用药前,凝血酶原时间长于用药前,血浆纤维蛋白原、D-二聚体水平高于用药前,且联合用药组各指标优于对照组(P<0.05或P<0.01);2组生理功能、躯体功能、精神状态、社会关系评分高于用药前,且联合用药组高于GP化疗组(P<0.01)。联合用药组与GP化疗组不良反应总发生率分别为22.50%、15.00%,组间比较差异无统计学意义(χ^(2)=0.738,P=0.390)。联合用药组1年存活率为65.00%,高于GP化疗组的42.50%(χ^(2)=4.073,P=0.044)。结论晚期NSCLC治疗中采用重组人血管内皮抑制素注射液联合化疗药物的可行性较高,可有效降低肿瘤标志物水平,延缓病情进展,提高患者生活质量及1年存活率,且具有一定安全性。

凝血酶激活的纤溶抑制物在肺部疾病中的研究进展

凝血酶激活的纤溶抑制物(TAFI)是一种血液凝块形成和纤溶过程中的重要调节因子,也是一种参与炎症调节的急性反应蛋白。TAFI在炎性应答过程和凝血、纤溶反应中起调控作用,并在肺部疾病(肺栓塞、急性肺损伤、肺癌等)发生、发展中发挥重要作用,这为凝血和纤溶瀑布之间的联系及炎症反应网络提供了重要线索。TAFI在肺部疾病中的发病机制涉及炎症反应、氧化应激以及纤维化等,但具体发病机制目前尚未明确。因此,未来深入研究TAFI在肺部疾病中的具体作用信号通路机制等具有重要的临床诊断及治疗价值,有助于改善患者预后。

益气温阳活血利水法在膜性肾病中的疗效及对相关抗体、凝血纤溶系统的影响

目的:探究益气温阳活血利水法在膜性肾病(MN)中的疗效及对相关抗体、凝血纤溶系统的影响。方法:选择2020年6月-2022年6月北京市昌平区中医医院收治的83例MN患者,根据随机数表法分为对照组(n=41)和观察组(n=42)。对照组进行常规MN治疗,观察组则在对照组的基础上加用益气温阳活血利水法进行治疗。比较两组的MN治疗总有效率、治疗前后的症状体征积分(颜面肢体水肿、神疲乏力及畏寒肢冷)、相关抗体指标[血清抗磷脂酶A2受体抗体(PLA2R-Ab)及磷脂酶A2-ⅠB(PLA2-ⅠB)]及凝血纤溶指标[组织纤维溶酶原激活物(t-PA)、纤溶酶原激活抑制剂(PAI-Ⅰ)及活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]。结果:观察组治疗总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组症状体征积分、相关抗体指标及凝血纤溶指标比较,差异无统计学意义(P>0.05);治疗1个疗程及2个疗程后,观察组各项症状体征积分均低于对照组,差异有统计学意义(P<0.05)。治疗1个疗程及2个疗程后,观察组PLA2R-Ab、PLA2-ⅠB及PAI-Ⅰ显著低于对照组,t-PA高于对照组,APTT、TT长于对照组,差异有统计学意义(P<0.05)。结论:益气温阳活血利水法应用于MN中的疗效较好,且可有效改善患者相关抗体及凝血纤溶状态。

基于临床检验指标建立肺腺癌患者浸润程度判别模型

目的·利用肿瘤标志物、凝血功能指标、血常规指标与生化指标等临床易得检验指标,建立非小细胞肺腺癌患者浸润程度的多因素判别模型。方法·回顾性选取2022年上海交通大学医学院附属胸科医院收治的肺腺癌患者,通过多因素Logistic回归分析筛选预测肺腺癌患者浸润程度的独立影响因素并建立回归模型,同时引入人工智能算法构建判别模型,采用受试者工作特征曲线下面积(area under curve,AUC)评价模型对肺腺癌患者浸润程度的判别能力。结果·共纳入肺腺癌患者202例,分为浸润前病变组(59例)以及浸润性病变组(143例)。多因素Logistic回归分析结果显示,尿素、嗜碱性粒细胞百分比、白蛋白浓度是预测肺腺癌患者浸润程度的独立影响因素(均P<0.05)。预测模型表达式为P=e^(X)/(1+e^(X)),其中X=(0.534×尿素浓度)+(1.527×嗜碱性粒细胞百分比)−(1.916×白蛋白浓度)+6.373。机器学习结果显示,纳入尿素、纤维蛋白原、白蛋白浓度、嗜碱性粒细胞百分比、前白蛋白、癌胚抗原(carcino embryonic antigen,CEA)6个指标时模型判别性能最佳。通过DeLong检验比较8种机器学习算法(分别基于岭回归、最小绝对收缩和选择算子、神经网络、随机森林、k近邻、支持向量机、决策树和自适应增强算法)的判别性能,选择AUC最高的岭回归算法,预测模型AUC为0.744(95%CI 0.656~0.832),敏感度为70.8%,特异度为70.2%。结论·使用尿素、纤维蛋白原、白蛋白浓度、嗜碱性粒细胞百分比、前白蛋白、CEA这6个指标建立综合判别模型,可有效预测肺腺癌患者肿瘤浸润程度,有望为临床肺腺癌分级判别和辅助治疗提供更精确的指导。

不同临床分期肺癌患者的凝血及纤溶指标表达差异分析

目的探讨与分析不同临床分期肺癌患者的凝血及纤溶指标的表达差异及其与疾病的相关性。方法回顾性选取2019年8月—2022年12月南通瑞慈医院诊治的156例肺癌患者的临床资料作为观察组(Ⅰ期100例、Ⅱ期30例、Ⅲ期26例),并选取100例同期在本院体检中心进行健康体检者纳入健康组,检测所有人群的凝血及纤溶指标并进行相关性分析。结果观察组的血浆纤维蛋白原(5.78±0.31)g/L高于健康组(2.57±0.21)g/L,观察组的血小板计数(234.40±11.58)×10^(9)/L高于健康组的(156.89±12.68)×10^(9)/L,差异有统计学意义(t=90.996、50.335,P均<0.05)。随着临床分期的增加,肺癌患者的血浆凝血酶原时间、D-二聚体、活化部分凝血活酶时间显著增加,凝血酶时间显著降低,差异有统计学意义(P均<0.05)。Ⅲ期肺癌患者的血小板计数、血浆纤维蛋白原含量均高于Ⅱ期、Ⅰ期患者,差异有统计学意义(P均<0.05)。在156例患者中,Spears-man秩相关分析法显示临床分期与血浆凝血酶原时间、D-二聚体、活化部分凝血活酶时间、纤维蛋白原、血小板存在正相关性(P均<0.05)。结论肺癌患者多伴随有凝血及纤溶指标表达异常,凝血及纤溶指标表达状况与肺癌患者的临床分期存在相关性。

基于产后出血预测评分的个性化用药方案预防剖宫产产后出血的效果及对凝血纤溶功能的影响

目的探讨基于产后出血预测评分的个性化用药方案预防剖宫产产后出血的效果及对凝血纤溶功能的影响。方法选取2018年6月至2021年6月收治的150例剖宫产产妇作为研究对象,将其随机分为对照组和观察组,每组75例。对照组采用益母草注射液、卡前列素氨丁三醇和缩宫素治疗,观察组采用基于产后出血预测评分的个性化用药方案治疗。比较两组的治疗效果。结果观察组的治疗总有效率明显高于对照组(P<0.05)。术后2、24 h,观察组的出血量少于对照组(P<0.05);术后3、7 d,观察组的宫底高度低于对照组(P<0.05)。术后24 h,观察组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于对照组,纤维蛋白降解产物(FDP)水平低于对照组,纤溶酶原激活剂抑制物-1(PAI-1)、抗凝血酶-Ⅲ(AT-Ⅲ)水平高于对照组(P<0.05)。术后24 h,观察组的过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)水平高于对照组,活性氧(ROS)水平低于对照组(P<0.05)。结论基于产后出血预测评分的个性化用药方案有助于提高剖宫产产后出血预防效果,减少产后出血量,促进宫底高度恢复,有效改善凝血纤溶功能,也能减轻氧化应激反应,值得推广。