不同肿瘤分期肺癌合并下肢静脉血栓患者的炎症因子、凝血及纤溶指标表达水平的差异及其与疾病的相关性分析  

Differences in the expression levels of inflammatory factors, coagulation and fibrinolytic indexes in patients with lung cancer complicated with lower extremity venous thrombosis and their correlation with disease

作　　者：赵娜 丁宁[2] 朱蓉 ZHAO Na;DING Ning;ZHU Rong(Department of Respiratory Medicine,Huai'an Clinical College of Xuzhou Medical University,Huai'an Jiangsu 223001,China;Department of Respiratory and Critical Care Medicine,Jiangsu Provincial People's Hospital,Nanjing Jiangsu 210029,China;Department of Respiratory and Critical Care Medicine,Huai'an Clinical College of Xuzhou Medical University,Huai'an Jiangsu 223001,China)

机构地区：[1]徐州医科大学淮安临床学院呼吸内科,江苏淮安223001 [2]江苏省人民医院呼吸与危重症医学科,江苏南京210029 [3]徐州医科大学淮安临床学院呼吸与危重症医学科,江苏淮安223001

出　　处：《临床和实验医学杂志》2023年第5期457-461,共5页Journal of Clinical and Experimental Medicine

基　　金：国家自然科学基金项目(编号:82070093)。

摘　　要：目的探讨不同肿瘤分期肺癌合并下肢静脉血栓患者的炎症因子、凝血及纤溶指标表达水平的差异及其与疾病的相关性。方法回顾性选择2017年3月到2022年3月于江苏省人民医院就诊的195例肺癌患者,根据是否合并下肢静脉血栓进行分组,将肺癌合并下肢静脉血栓患者作为观察组(60例)、肺癌未发生下肢静脉血栓患者作为对照组(135例);观察组按照不同肿瘤分期分为:Ⅰ期18例,Ⅱ期32例,Ⅲ期10例。比较观察组和对照组肺癌患者手术前和手术后24 h炎症因子[高敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、降钙素原(PCT)]、凝血功能指标[血小板计数(PLT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)]和纤溶指标[D-二聚体(D-D)、血小板聚集率(PAgT)、凝血酶-抗凝血酶Ⅲ复合物(TAT)]水平;比较不同肿瘤分期下肢静脉血栓患者术后24 h炎症因子水平、凝血和纤溶指标水平;对肺癌合并下肢静脉血栓影响因素应用Logistic回归分析法进行多因素分析。结果手术后24 h,两组患者hs-CRP、IL-6、TNF-α和PCT水平较手术前升高,观察组hs-CRP、IL-6、TNF-α和PCT水平高于对照组,差异均有统计学意义(P<0.05)。手术后24 h,两组PLT、FIB、APTT和PT指标较手术前升高,观察组患者PLT、FIB、APTT和PT指标高于对照组,差异均有统计学意义(P<0.05)。手术后24 h,两组患者D-D、TAT水平较手术前升高,观察组D-D、PAgT和TAT高于对照组,差异均有统计学意义(P<0.05)。不同肿瘤分期肺癌合并下肢静脉血栓患者CRP、IL-6、FIB和PT水平比较,差异均无统计学意义(P>0.05);TNF-α、PCT、PLT、APTT、D-D、PAgT、TAT水平比较,差异均有统计学意义(P<0.05)。经Logistic多因素回归分析结果显示,D-D、TAT水平是影响肺癌患者下肢静脉血栓发生的独立危险因素(OR=8.230,95%CI:2.447~13.562;OR=10.847,95%CI:8.976~15.633;P<0.05)。结论肺癌合并�Objective To investigate the differences in the expression levels of inflammatory factors,coagulation and fibrinolysis indexes in lung cancer patients with lower extremity venous thrombosis at different tumor stages and their correlation with disease.Methods A total of 195 lung cancer patients treated in Jiangsu Provincial People's Hospital from March 2017 to March 2022 were selected and divided into observation group(n=60)and control group(n=135)according to whether they were complicated with lower extremity venous thrombosis.The observation group was divided into 18 cases of stageⅠ,32 cases of stageⅡand 10 cases of stageⅢaccording to different tumor stages.The levels of inflammatory factors[high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT)],coagulation indexes[platelet count(PLT),fibrinogen(FIB),activated partial thromboplastin time]before and 24 hours after surgery were compared between the observation group and the control group(APTT),prothrombin time(PT)and fibrinolytic index[D-dimer(D-D),platelet aggregation rate(PAgT),thrombin antithrombinⅢcomplex(TAT)]levels;The levels of inflammatory factors,coagulation and fibrinolysis in patients with lower extremity venous thrombosis of different tumor stages were compared 24 hours after operation.Logistic regression analysis was used to analyze the influencing factors of lung cancer complicated with lower extremity venous thrombosis.Results 24 hours after operation,the levels of hs-CRP,IL-6,TNF-αand PCT in the two groups were higher than those before operation,the levels of hs-CRP,IL-6,TNF-αand PCT in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).24 hours after operation,the levels of PLT,FIB,APTT and PT of the two groups were higher than those before operation,and the levels of PLT,FIB,APTT and PT of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05

关 键 词：肺癌 不同肿瘤分期 下肢静脉血栓 炎症因子 凝血指标 溶纤指标 相关性 

分 类 号：R734.2[医药卫生—肿瘤] R543.6[医药卫生—临床医学]