血栓弹力描记术在评价恶性肿瘤病人凝血功能及化疗对凝血功能影响的价值  

Clinical value of thromboelastography in evaluating malignancy thrombophilia and the effects on coagulation of chemotherapy

作　　者：亓艳[1] 李雪梅[2] 徐春园[3] QI Yan LI Xue-mei XU Chun-yuan(Department of Clinical Laboratory ,Qingdao Municipal Hospital ,Qingdao 266011 ,China)

机构地区：[1]青岛市市立医院检验科,山东青岛266011 [2]青岛市市立医院血液科,山东青岛266011 [3]青岛市市立医院肿瘤科,山东青岛266011

出　　处：《中国实验诊断学》2017年第4期592-594,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的评价血栓弹力描记术在监测恶性肿瘤病人凝血功能及化疗对凝血功能影响的价值。方法 44例恶性肿瘤患者化疗前、后以及34例健康对照分别行血栓弹力描记术、血常规、常规凝血项目测定。结果恶性肿瘤病人化疗前、后分别与健康对照组比较,R值、K值均低于健康对照组(P<0.05),α角均高于对照组(P<0.05),MA值差异无显著性(P>0.05)。PLT仅在化疗后与健康对照组差异有意义(P<0.05),化疗前后恶性肿瘤病人DD、FIB均较对照组升高(P<0.05)。肿瘤病人化疗前后相比,R时间缩短(P<0.01),K时间、α角、MA值无明显变化(P>0.05),PLT显著降低(P<0.01),DD升高、FIB降低(P<0.05)。结论恶性肿瘤病人存在血栓形成倾向,化疗会加剧这种状态,血栓弹力描记术在传统凝血检查基础上连续全面反映恶性肿瘤病人及恶性肿瘤化疗过程凝血全貌。Objective Clinical value of thromboelastography in evaluating malignancy hypercoagulability and the effects on coagulation of chemotherapy Methods 44 patients with malignant tumors were enrolled as an observed group analyzing the changes of plasma R,K,Angle,MA,Platelet,D-Dimer,Fibrinogen pre and post chemotherapy.34 healthy subjects were enrolled as a control group for comparison.Results The values of R,K were shortened（P〈0.05）,Angle was increased（P〉0.05）,and the values of D-Dimer,Fibrinogen were increased（P〈0.05）,MA had no significantly different（P〉0.05）,in patients pre and post chemotherapy compared with healthy subjects,and the value of Platelet was decreased after chemotherapy（P〈0.05）.The values of R were decreased（P〈0.01）,K,Angle,MA had no significant different（P〈0.05）,and the value of Platelet was significantly decreased（P〈0.01）,D-Dimer increased and FIB decreased（P〈0.05）.Conclusion The patients with malignant tumors exist thrombophilia,and chemotherapy can influence it.Thromboelastography might be a much more sensitive method to reveal the existence of hypercoagulation status in them compared to conventional coagulation examination.

关 键 词：血栓弹力描记术 恶性肿瘤 化学疗法 血栓形成倾向 

分 类 号：R730.43[医药卫生—肿瘤]