晚期肺癌患者凝血及纤溶异常与血栓形成的相关性  

Correlation of thrombosis with blood coagulation and fibrinolytic abnormalities in patients with advanced lung cancer

作　　者：姬利萍[1] 邝先奎 杨佳[1] 李洁瑶[1] 董文杰[1] 闫焱[1] 王丽萍[1] 

机构地区：[1]郑州大学第一附属医院肿瘤科,郑州450052 [2]项城市第一人民医院肿瘤科,河南项城466200

出　　处：《中华实用诊断与治疗杂志》2014年第12期1203-1204,1207,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家青年科学基金项目(81302120);河南省医学科技攻关计划项目(201303038);河南省科技厅基础与前沿项目(122300410155)

摘　　要：目的探讨晚期肺癌患者凝血、纤溶异常与血栓形成的相关性。方法检测95例晚期肺癌患者(肺癌组)及50例体检健康者(对照组)凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、血浆纤维蛋白原、D-二聚体水平及血小板计数,按不同病理类型及分期进行对比分析。结果肺癌组血清血浆纤维蛋白原为(6.0±1.1)g/L,血小板计数为(570.1±53.2)×109,D-二聚体为(1.3±0.3)mg/L,对照组分别为(2.9±0.5)g/L、(220.0±41.2)×109、(0.3±0.1)mg/L,2组比较差异有统计学意义(P<0.05);肺癌组活化部分凝血活酶时间((35.2±12.8)s)、凝血酶时间((12.8±0.7)s)、凝血酶原时间((12.1±1.2)s)与对照组((26.3±2.1)、(12.6±0.3)、(11.4±1.0)s)比较差异无统计学意义(P>0.05);小细胞癌、腺癌患者血浆纤维蛋白原((6.3±0.4)、(6.1±1.3)g/L)、D-二聚体((2.1±0.2)、(1.5±0.1)mg/L)高于鳞癌患者(5.6±1.5)g/L,(0.4±0.2)mg/L)(P<0.05);肺癌组不同临床分期患者血浆纤维蛋白原、D-二聚体、血小板计数比较差异无统计学意义(P>0.05)。结论晚期肺癌患者处于高凝、抗凝功能降低、继发纤溶亢进的状态,易导致血栓形成。Objective To investigate the correlation of thrombosis with blood coagulation and fibrinolytic abnormalities in patients with advanced lung cancer.Methods Prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,plasma fibrinogen（FIB）,D-dimer（D-D）levels and platelet count（PLT）were determined in 95 patients with advanced lung cancer（cancer group）and 50 healthy volunteers（control group）,and were analyzed according to different histological types and clinical stages.Results There were significant differences in the FIB,PLT and D-D level between cancer group（（6.0±1.1）g/L,（570.1±53.2）×10^9,（1.3±0.3）mg/L）and control group（（2.9±0.5）g/L,（220.0±41.2）×10^9,（0.3±0.1）mg/L）（P0.05）.There were no significant differences in APTT,TT and PT in cancer group（（35.2±12.8）,（12.8±0.7）,（12.1±1.2）s）and control group（（26.3±2.1）,（12.6±0.3）,（11.4±1.0）s）（P〉0.05）.FIB and D-D were significantly higher in patients with small cell lung carcinoma（（6.3±0.4）g/L,（2.1±0.2）mg/L）and adenocarcinoma（（6.1±1.3）g/L,（1.5±0.1）mg/L）than those in squamous cell carcinoma（（5.6±1.5）g/L,（0.4±0.2）mg/L）（P〈0.05）.There were no significant differences in FIB,D-D and PLT in different clinical stages（P〉0.05）.Conclusion In the status of high-coagulation,decreased anticoagulation function and secondary hyperfibrinolysis,the patients with advanced lung cancer are susceptible to thrombosis.

关 键 词：肺癌 凝血 纤溶 血栓 

分 类 号：R734.2[医药卫生—肿瘤]