凝血功能检测在胃癌分期和转移中的临床意义  

Clinical significance of coagulation function detection in gastric cancer staging and metastasis

作　　者：赵星[1] 霍怡杉 郭凡[1] 桂霞[1] 马秀敏 ZHAO Xing;HUO Yishan;GUO Fan;GUI Xia;MA Xiumin(Department of Blood Transfusion,Affiliated Tumor Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)

机构地区：[1]新疆医科大学附属肿瘤医院输血科,新疆乌鲁木齐830054

出　　处：《国际检验医学杂志》2022年第15期1890-1893,1899,共5页International Journal of Laboratory Medicine

摘　　要：目的运用血栓弹力图(TEG)及凝血指标监测胃癌患者凝血功能,探讨两种方法在评价胃癌临床分期、转移中的临床价值。方法选取2020年6月至2021年6月该院诊治的170例胃癌患者作为胃癌组,另选取同期100例体检健康者作为对照组。检测受试者的TEG和凝血指标[凝血反应时间(R)、血块形成时间(K)、α角、最大振幅(MA)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(D-D)和血小板计数(PLT)],分析TEG和凝血指标在胃癌组和对照组,以及不同TNM分期和有无胃癌转移患者间的差异。结果与对照组比较,胃癌组R、K缩短,α角、MA增大,PLT及D-D、FIB水平升高,差异均有统计学意义(P<0.05)。在不同TNM分期胃癌患者中,Ⅲ期、Ⅳ期R较Ⅰ期缩短(P<0.05),Ⅳ期PLT高于Ⅱ期(P<0.05),Ⅲ期、Ⅳ期D-D水平高于Ⅰ期(P<0.05),Ⅳ期D-D水平高于Ⅱ期(P<0.05)。在有无胃癌转移患者中,胃癌转移患者MA、PLT及D-D水平均较于无转移患者升高(P<0.05)。结论胃癌患者TNM分期增高及转移时血液高凝状态更为明显。监测凝血功能可以帮助临床医生判断患者凝血状态,预防静脉血栓发生,还可评估胃癌进展情况。Objective To use thromboelastography(TEG)and coagulation indexes to monitor the coagulation function of gastric cancer patients,and to investigate the clinical value of the two methods in evaluating the clinical stage and distant metastasis of gastric cancer.Methods A total of 170 gastric cancer patients diagnosed and treated in this hospital from June 2020 to June 2021 were selected as the gastric cancer group,and another 100 healthy individuals who underwent physical examination during the same period were selected as the control group.TEG and coagulation indexes of subjects[coagulation reaction time(R),clot formation time(K),αangle,maximum amplitude(MA),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(Fib),D-dimer(D-D)and platelet count(PLT)]were detected,and the differences of TEG and coagulation indexes between gastric cancer group and control group,as well as patients with different TNM stages and with or without gastric cancer metastasis were analyzed.Results Compared with in the control group,R and K were shortened,αangle and MA increased,PLT and the levels of D-D and FIB increased in the gastric cancer group,and the differences were statistically significant(P<0.05).Among patients with gastric cancer of different TNM stages,the R in stageⅢandⅣwas shorter than that in stageⅠ(P<0.05),the PLT in stageⅣwas higher than that in stageⅡ(P<0.05),the level of D-D in stageⅢandⅣwas higher than that in stageⅠ(P<0.05),and the level of D-D in stageⅣwas higher than that in stageⅡ(P<0.05).In patients with or without gastric cancer metastasis,the MA,PLT and the level of D-D in patients with gastric cancer metastasis were higher than those in patients without metastasis(P<0.05).Conclusion The hypercoagulable state of blood is more obvious in patients with gastric cancer with increased TNM stage and metastasis.The monitoring of coagulation function can help clinical doctors determine the coagulation status of patients,prevent the occurrence of venous thrombosis,and evaluate t

关 键 词：凝血功能 血栓弹力图 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]