肺癌晚期患者临终前血小板和D-聚体的变化及临床意义  

Dynamic variation of platelets and D-dimer on patients with advanced lung cancer before death: a retrospective case study

作　　者：朱江红[1] 艾亮[1] 刘勇[1] 孟令占[1] 周建云[2] 程俊[1] 

机构地区：[1]重庆市中医院肿瘤科,重庆400011 [2]第三军医大学新桥医院,重庆400037

出　　处：《中华肺部疾病杂志（电子版）》2015年第5期43-45,共3页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：国家自然科学基金(81201498)

摘　　要：目的探讨肺癌晚期患者临终前血小板(PLT)及D-二聚体(D-dimer)指标的变化及临床意义。方法回顾性分析2012年1月至2014年6月临终前就诊于重庆市中医院肿瘤科且未进行放化疗措施的肺癌晚期患者97例,对患者临终前4周,2周及3 d的PLT及D-dimer指标进行动态性比较分析。结果肺癌晚期患者临终前2周PLT值(204.7±16.11)较临终4周前(234.2±15.33)有所下降,但无统计学意义(P=0.0646);临终3 d前PLT值(166.1±14.74)和临终2周前(204.7±16.11)相比明显下降(P=0.0020)。患者D-dimer值在临终前有升高趋势(2.17±0.87),并且临终前3 d PLT(166.1±14.74)与D-dimer值(2.38±2.29)成负相关(r=-0.402,P=0.034)。结论肺癌晚期患者临终前PLT值明显下降,而D-dimer值升高,表明患者可能出现多部位的血栓,导致凝血因子PLT的耗竭性降低,提示患者病情的恶化。Objective To investigate clinical significance of platelets（ PLT） and D-dimer variation on patients with advanced lung cancer before death. Methods A total of 97 patients died from advanced lung cancer from January 2012 to June 2014 at Department of Oncology,Chongqing Hospital of Traditional Chinese Medicine were collected and analyzed. The PLT and D-dimer value at different time points,（ 4 weeks,2 weeks and 3 days before death） were compared. Results PLT value of patients were lower at 2 weeks before death（ 204. 7 ± 16. 11） than 4 weeks before death（ 234. 2 ± 15. 33）,but there was no statistical significance.Moreover,PLT value was significant difference between 2 weeks（ 204. 7 ± 16. 11） or 3 days（ 166. 1 ± 14. 74）time point（ P = 0. 0020）. However,D-dimer value of patients was increasing. And significant negative correlation was found between PLT（ 166. 1 ± 14. 74） and D-dimer（ 2. 38 ± 2. 29） at 3 day time piont（ r =- 0. 402,P = 0. 034）. Conclusion PLT declining and D-dimer rising may be the precursor signal of thrombosis. It indicates patients condition deteriorated.

关 键 词：晚期肺癌 血小板 D-二聚体 

分 类 号：R563[医药卫生—呼吸系统]