血栓弹力图联合分子标志物对肺癌患者凝血功能的评估价值及其与预后的关系  

Evaluation value of thrombelastogram combined with molecular markers on coagulation function in patients with lung cancer and its relationship with prognosis

作　　者：施珊娜 刘晓静[1] 许萍[1] 吕齐法[1] 叶涵[1] 曾丽赣 刘丹丹 徐兴平 SHI Shanna;LIU Xiaojing;XU Ping;LYU Qifa;YE Han;ZENG Ligan;LIU Dandan;XU Xingping(Department of Respiratory,the Fourth Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang 330000,China)

机构地区：[1]南昌大学第四附属医院呼吸科,江西南昌330000

出　　处：《中国当代医药》2023年第23期7-11,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(SKJP220210906)。

摘　　要：目的探讨血栓弹力图(TEG)联合分子标志物对肺癌患者凝血功能的评估及与预后的关系。方法纳入南昌大学第四附属医院2019年8月至2021年8月收治的肺癌患者50例,根据有无静脉血栓栓塞分成高凝组(n=22)、非高凝组(n=28)。利用TEG评估患者的凝血反应时间(R值)、最大振幅(MA值)、凝血形成速率(Angle角)、血凝块形成时间(K值)、凝血指数(CI值),比较两组分子标志物水平,包括纤溶酶-α2抗纤溶酶复合物(PIC)、凝血酶-抗凝血酶复合物(TAT)、血栓调节蛋白(TM)、组织型纤溶酶原激活剂-纤溶酶原激活物抑制剂-1(TPAI-C),分析TEG联合分子标志物对肺癌患者凝血功能的评估价值及与预后的关系。结果高凝组R值、K值低于非高凝组,MA值、Angle角、CI值高于非高凝组,且高凝组血浆PIC、TAT、TM、TPAI-C水平高于非高凝组,差异有统计学意义(P<0.05)。肺癌患者的R值、K值与PIC、TAT、TM、TPAI-C呈负相关,MA值、Angle角、CI值与PIC、TAT、TM、TPAI-C呈正相关,差异有统计学意义(P<0.05)。TEG联合分子标志物评估肺癌患者凝血功能的AUC为0.883,敏感度86.36%,特异度92.86%。死亡组R值、K值低于生存组,MA值、Angle角、CI值高于生存组,且死亡组血浆PIC、TAT、TM、TPAI-C水平高于生存组,差异有统计学意义(P<0.05)。结论TEG联合分子标志物对肺癌患者凝血功能具有较高评估价值,且TEG参数、分子标志物之间存在相关性,并与患者预后有关。Objective To explore the relationship between thrombelastogram(TEG)and molecular markers in the assessment of coagulation function and prognosis in patients with lung cancer.Methods Fifty patients with lung cancer admitted to the Fourth Affiliated Hospital of Nanchang University from August 2019 to August 2021 were included and divided into high coagulation group(n=22)and non-high coagulation group(n=28)according to whether there was venous thromboembolism.TEG was used to evaluate the patients'coagulation response time(R value),maximum amplitude(MA value),coagulation rate(Angle),clot formation time(K value),and coagulation index(CI value).The levels of molecular markers including plasminα2 plasmin inhibitor complex(PIC),thrombin-antithrombin complex(TAT),thrombomodulin(TM),tissue plasminogen activator-plasminogen activator inhibitor-1 complex(TPAI-C)were compared between the two groups.To analyze the value of TEG combined molecular markers in the evaluation of coagulation function in patients with lung cancer and its relationship with prognosis.Results The R value and K value of high coagulation group were lower than those of non-high coagulation group,the MA value,Angle and CI value were higher than those of non-high coagulation group,and the plasma levels of PIC,TAT,TM and TPAI-C of high coagulation group were higher than those of non-high coagulation group,the differences were statistically significant(P<0.05).The R value and K value of lung cancer patients were negatively correlated with PIC,TAT,TM and TPAI-C,while the MA value,Angle and CI value were positively correlated with PIC,TAT,TM and TPAI-C,the differences were statistically significant(P<0.05).The AUC of TEG combined with molecular markers was 0.883,with a sensitivity of 86.36%and specificity of 92.86%.R and K values of death group were lower than survival group,MA,Angle and CI values were higher than survival group,and plasma levels of PIC,TAT,TM and TPAI-C of death group were higher than survival group,the differences were statistically significa

关 键 词：肺癌 凝血功能 血栓弹力图 分子标志物 预后 

分 类 号：R734.2[医药卫生—肿瘤]