原发性肝癌患者治疗方式间凝血功能的交互效应及其对远期生存率的评价  

Interaction effect of coagulation among different treatments and its effect on long-term survival for primary liver cancer

作　　者：刘妮 赵珊[1] 彭晶 杨金宇 郭炫[1] LIU Ni;ZHAO Shan;PENG Jing;YANG Jin -yu;GUO Xuan(Clinical Laboratory, the First Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an, Shaanxi 710061, China)

机构地区：[1]西安交通大学第一附属医院检验科,陕西西安710061 [2]西安市中医医院检验科,陕西西安710061

出　　处：《中国卫生检验杂志》2018年第13期1537-1540,共4页Chinese Journal of Health Laboratory Technology

基　　金：陕西省科技攻关项目(2009K01-78)

摘　　要：目的探索凝血功能对不同治疗方式的原发性肝癌患者远期生存率的影响及意义。方法通过110例原发性肝癌患者凝血指标在保守治疗、介入治疗、手术治疗3种常见治疗方式前后的变化与分布特点,并结合各凝血指标的交互效应及随访生存分析,比较3种治疗方式治疗前后凝血功能的变化及分组因素的交互效应,分析凝血指标和原发性肝癌晚期患者远期生存率的关系。结果原发性肝癌患者与正常对照组凝血功能差异有统计学意义(P<0.05);且APTT、D-dimer、FDP在3种治疗方式治疗后均比治疗前降低(P<0.05);PT、D-dimer、PLCR在3组治疗前后与治疗方式间的交互效应差异有统计学意义(P<0.05)。生存分析显示,保守治疗组比介入治疗组和手术治疗组生存期短,差异有统计学意义(P<0.05)。比较远期生存率:手术治疗组>介入治疗组>保守治疗组。结论手术治疗较介入治疗与保守治疗的凝血指标改善显著,且远期生存率高。凝血功能改善越显著,患者的远期生存率相应越高。Objective To explore the effect and significance of coagulation on long-term survival of patients with primary liver cancer under different treatments. Methods By analyzing the changes and distribution characteristics of coagulation parameters in patients with primary liver cancer before and after conservative treatment,interventional therapy,and surgical treatment,combined with the interaction effect of each coagulation index and follow-up survival analysis,the changes of coagulation function and the interaction of grouping factors before and after treatment were compared among the three treatment methods. The relationship between coagulation parameters and long-term survival of patients with advanced hepatocellular carcinoma was analyzed. Results The difference of coagulation function between primary liver cancer patients and the normal control group was statistically significant（ P〈0. 05）,and APTT,D-dimer and FDP were lower than that before treatment（ P〈0. 05）. For PT,D-dimer,and PLCR,there was statistical significance on the difference,compared with the interaction effect before and after treatment（ P〈0. 05）. The survival analysis showed that the survival time of the conservative treatment group was shorter than the intervention treatment group and the surgical treatment group,with the differences statistically significant（ P〈0. 05）.Long-term survival rate showed a decrease in surgical treatment group,intervention treatment group,conservative treatment group. Conclusion Surgical treatment improved blood coagulation more effectively,compared with intervention treatment or conservative treatment,and had higher long-term survival. The more the coagulation function pronounces,the higher the patient＇s forward survival rate is.

关 键 词：原发性肝癌 凝血功能 治疗方式 交互效应 生存率 

分 类 号：R735.7[医药卫生—肿瘤]