血浆D-二聚体及纤维蛋白原在非小细胞肺癌患者围术期监测中的应用价值  

Value of plasma D-dimer,fibrinogen levels monitoring in non-small cell lung cancer patients in perioperative period

作　　者：江吕泉[1] 高坤祥[2] 郑建[1] 陈建[1] 吴昊[1] 陈林松[1] 

机构地区：[1]武警江苏总队医院胸外科,扬州225003 [2]第四军医大学唐都医院胸外科,西安710038

出　　处：《武警医学》2013年第5期414-416,419,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨血浆D-二聚体及纤维蛋白原(fibrinogen,FIB)在非小细胞肺癌患者手术前、后监测中的应用价值。方法测定254例非小细胞肺癌患者和52例肺部良性肿瘤患者血浆D-二聚体及FIB水平,对其术后D-二聚体及FIB变化进行随访监测。结果非小细胞肺癌组术前、后血浆D-二聚体及FIB水平明显高于良性肿瘤组(P<0.01);非小细胞肺癌患者血浆D-二聚体及FIB水平随分期增加而明显升高,差异有统计学意义(P<0.01)。肺癌组中15例术后出现血栓性疾病前其D-二聚体及FIB水平或一过性下降后突然升高。结论监测非小细胞肺癌患者手术前后血浆D-二聚体及FIB浓度,有助于术前筛查血栓高风险人群,改善患者预后。Objective Bleeding or thrombotic diseases are easily to be found in non-small cell lung cancer（NSCLC） patients, because the equilibrium of their coagulation system might be disturbed due to tumor burden or surgical injury.In the study, we studied the value of plasma D-dimer and fibrinogen levels monitoring in patients with non-small cell lung cancer before and after surgery. Methods The plasma D-dimer and fibrinogen levels were measured in 254 patients with non-small cell lung cancer and 52 patients with benign lung tumor,and then we followed up to record the D-dimer and fibrinogen levels change in postoperative patients. Results The plasma levels of D-dimer and fibrinogen in non-small cell lung cancer patients were found to be significantly higher than those in patients with benign lung tumor （P〈0.01）.Significant differences in D-dimer and fibrinogen levels were found among different stages of non-small cell lung cancer （P〈0.01）,which suggested that coagulation and fibrinolysis dysfunction in patients with non-small cell lung cancer aggravated along with the progression of disease.The D-dimer and fibrinogen levels kept at a high level or rose suddenly after a transient decrease in 15 patients who had thrombotic diseases after operation. Conclusions Monitoring the plasma D-dimer and fibrinogen levels in patients with non-small cell lung cancer before and after operation helps find out those who have high risk of thrombotic diseases and preventing thrombtic disease after operation. It also helps us to strive for early prevention,early diagnosis,early treatment,nd to improve the prognosis of the patients.

关 键 词：D-二聚体 纤维蛋白原 非小细胞肺癌 血栓 围术期 

分 类 号：R734.2[医药卫生—肿瘤]