肺癌患者血浆D-二聚体、纤维蛋白原水平分析  

Analysis of D-dimer and fibrinogen level in lung cancer patients

作　　者：邓淑萍[1] 靳建军[1] 田蕊[1] 康贝贝[1] 李健康[1] 陆青[1] 王静[1] 

机构地区：[1]郑州大学第一附属医院呼吸与危重症二科,450052

出　　处：《国际呼吸杂志》2014年第12期922-925,共4页International Journal of Respiration

摘　　要：目的 回顾性分析肺癌患者血浆D-二聚体（D-dimer,D-D）、纤维蛋白原（fibrinogen,FIB）水平,探讨肺癌患者高凝状态的临床特征.方法 检测223例肺癌初治患者血浆D-D及FIB水平,按性别、年龄、类型、分期进行分组比较并比较化疗前后D-D、FIB水平.结果 223例患者中D-D水平升高129例（57.8％）,FIB水平升高97例（43.5％）;伴有远处转移的患者142例,D-D水平升高100例（70.4％）,FIB水平升高74例（52.1％）.D-D、FIB水平在不同性别、年龄分组中,差异无统计学意义（P＞0.05）.病理分型分组中,腺癌组D-D水平较鳞癌组、小细胞癌组明显升高（P＜0.05）,鳞癌组FIB水平较腺癌组高（P＜0.05）.非小细胞肺癌中,随着分期的升高,D-D水平相应升高（P＜0.05）,Ⅳ期患者D-D水平较Ⅲ期患者高（P＜0.05）,各分期FIB水平比较,差异无统计学意义（P＞0.05）.小细胞肺癌中,广泛期D-D、FIB水平较局限期高（P＜0.05）.化疗后,有效组（完全缓解及部分缓解）D-D、FIB水平较治疗前下降（P＜0.05）;稳定组无明显变化（P＞0.05）;进展组较治疗前明显上升（P＜0.05）.结论 肺癌患者普遍存在高凝状态,以腺癌、晚期,尤其是伴有远处转移者明显.化疗缓解时高凝状态有所缓解,进展时高凝状态较前加重,因此D-D、FIB可以作为评估化疗疗效的间接指标,也可以作为监测肺癌高凝状态变化的指标.Objective To analyse the levels of D-dimer and fibrinogen （FIB） in lung cancer patients,and discuss the clinical characteristics in lung cancer patients with hypercoagulable state.Methods The levels of plasm D-dimer and FIB in 223 lung cancer patients were detected and compared,grouping them by gender,age,pathological type,and clinical stage.The levels of D-dimer and FIB before and after chemotherapy were compared.Results Lung cancer patients with high-level D-dimer and high-level FIB accounted for 57.8％ and 43.5％,respectively.The ratio was higher in metastasis patients （70.4％,52.1％,respectively）.The D-dimer level in adenocarcinoma patients was higher than other types,the level of FIB in patients with squamous cell lung cancer was higher than that in patients with adenocarcinoma （P ＜ 0.05）.In non-small cell lung cancer,D-dimer level increased as stage progressed.D-dimer level in stage Ⅳ was higher than that in stage Ⅲ （P ＜0.05）.There was no statistical significance in FIB level among all stages （P ＞ 0.05）.In small cell lung cancer,the levels of D dimer and FIB in extensive disease were higher than those in limited disease.The D-dimer,FIB levels after chemotherapy depended on lesions remission,when tumor got complete or partial response,it declined;vice versa.Conclusions Lung cancer has a high risk of hypercoagulability,especially in adenocarcinoma patients,advanced stage,in patients who have distant metastasis.After chemotherapy,the levels of D-dimer and FIB are correlated with the tumor remission,so D-dimer and FIB are indirect indexes to estimate the chemotherapeutic effect and hypercoagulable state of lung cancer.

关 键 词：肺癌 D-二聚体 纤维蛋白原 

分 类 号：R734.2[医药卫生—肿瘤]