结直肠癌患者血液高凝状态的临床研究
作者: |
1,2徐勇,
2张侠
1 安徽医科大学研究生院,合肥 230032 2 中国人民解放军陆军总医院肿瘤科,北京 100700 |
通讯: |
张侠
Email: Caiman-xy@foxmail.com |
DOI: | 10.3978/j.issn.2095-6959.2018.05.018 |
摘要
目的:研究结直肠癌初诊患者血液高凝状态(hypercoagulable state,HCS)特征及其临床意义。方法:收集153例结直肠癌初诊患者凝血功能及相关指标并进行统计学分析。结果:153例结直肠癌初诊患者中113例(73.86%) HCS,其中D-二聚体(D-dimmer,D-D)升高98例(86.72%),PLT升高58例(51.33%),纤维蛋白原(fibrinogen,FIB)升高34例(30.09%),凝血活酶时间(activated partial thromboplastin time,APTT)缩短6例(5.31%),血浆凝血酶原时间(plasma prothrombin time,PT)缩短4例(3.54%);其中两项均异常47例(41.59%),以PLT,D-D升高居多32例(28.32%);其中3项及以上均异常18例(15.66%),以PLT,FIB,D-D升高居多15例(13.27%)。年龄≥60岁较<60岁者PLT,FIB高(P<0.05);性别差异无统计学意义(P>0.05);ECOG≥2分较<2分者PLT,FIB,D-D高(P<0.01);既吸烟又饮酒较无烟酒嗜好者D-D高(P<0.01);无合并疾病较合并者PLT,D-D低(P<0.01);FIB,PLT和D-D在I~II与III,IV期差异均有统计学意义(P<0.05)。年龄≥60岁,ECOG≥2分,有烟酒嗜好,合并基础疾病及转移均是HCS危险因素(P<0.05)。结论:结直肠癌患者常存在HCS,以PLT,FIB,D-D升高居多;年龄≥60岁,ECOG≥2分,有烟酒嗜好、有合并基础疾病及肿瘤远处转移均是HCS危险因素,其中烟酒嗜好、合并基础疾病、肿瘤远处转移更为显著。
关键词:
结直肠癌;高凝状态;凝血指标;转移
Clinical studies of hypercoagulable state in patients with colorectal cancer
CorrespondingAuthor: ZHANG Xia Email: Caiman-xy@foxmail.com
DOI: 10.3978/j.issn.2095-6959.2018.05.018
Abstract
Objective: To investigate the characteristics of coagulation indexes in patients with colorectal cancer and its clinical significance. Methods: Data of coagulation index collected from 153 colorectal cancer patients were statistically analyzed. Results: Among 153 cases of colorectal cancer, 113 cases (73.86%) of patients were with blood hypercoagulability, in which 98 cases (86.72%) with D-D increased, 58 cases (51.33%) with PLT elevated, 34 cases (30.09%) with FIB elevated, 6 cases (5.31%) with APTT shortened, 4 cases (3.54%) with PT shortened; 47 cases (41.59%) with two abnormal indexes, in which 32 cases (28.32%) with PLT, D-D increased; 18 cases (15.66%) with three or more abnormal indexes, in which 15 cases (13.27%) with PLT, FIB and D-D increased. PLT, FIB levels in the ≥60 years group were higher than those in the <60 years group (P<0.05); there was no statistically significant difference in gender (P>0.05). PLT, FIB and D-D levels in the ECOG score ≥2 group were higher than than those in the ECOG score <2 group (P<0.05); D-D levels in both smoking and drinking group were higher than that in the non-smoking and non-drinking group (P<0.01); PLT, D-D levels in the no merger diseases group were lower than that in the merger group (P<0.01); the differences in FIB, PLT, D-D among grade I–II, III and IV were all significantly different (P<0.01). Age ≥60 years, ECOG score ≥2, smoking and drinking, combined diseases and metastasis of colorectal cancer were risk factors of HCS (P<0.05). Conclusion: The colorectal cancer patients’ blood is often hypercoagulable, in which elevated PLT, FIB and D-D were the main abnormal coagulation indexes. Age ≥60 years, ECOG score ≥2, especially smoking and drinking, combined diseases and metastasis of colorectal cancer, are risk factors of hypercoagulability.
Keywords:
colorectal cancer; hypercoagulable state; coagulation index; metastasis