中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
3期
290-294
,共5页
胃癌%凝血指标%血小板%临床分期
胃癌%凝血指標%血小闆%臨床分期
위암%응혈지표%혈소판%림상분기
Gastric carcinoma%Coagulation index%Platelet%Clinical stage
目的 探讨胃癌患者术前外周血五项凝血指标与胃癌的临床分期、胃癌转移之间的相关性,以及不同临床分期患者的凝血状况及其临床意义.方法 选择首次诊断为胃癌的868例患者(胃癌组),并以同期住院的腹股沟疝患者213例作为对照组.观察两组患者术前外周血五项凝血指标:凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FBG)、血浆凝血酶时间(TT)和血小板(PLT)计数,对其结果进行统计学分析.结果 (1)胃癌组与对照组比较,外周血血浆PT[ (11.51±1.21)s与(11.27 ±0.91)s,t=-3.226.P＜0.01]、FBG[(3010.0±470.4)mg/L与(2307.1±651.8)mg/L,t=-4.240,P＜0.01]、PLT计数[(238.57±78.50)x 109/L与(206.79±61.01)×109/L,t=-5.514,P＜0.01]明显增高.(2)两组外周血FBG差异具有统计学意义(p＜0.05)；血浆PT、PLT计数明显增高,差异有统计学意义(P＜0.01)；胃癌组各临床分期外周血APTT、TT和健康对照组相比,差异无统计学意义(P均＞0.05).(3)胃癌无转移组与有转移组相比,术前外周血PT[ (11.41±0.99)s与(11.57±1.32)s,t=-2.095,P＜0.05]延长、FBG含量[(2639.1±748.6)mg/L与(3233.2±591.60)mg/L,t=-2.307,P＜0.05]增加,PLT计数[(224.02±76.94)×109/L与(247.32±78.37)×109/L,t=-4.299,P＜0.01]显著增加.(4)胃癌患者外周血五项凝血指标与临床分期的相关分析,PT(r=0.071,P＜0.05)、FBG(r =0.271,P＜0.01)、PLT(r =0.166,P＜0.01)呈正相关,TT(r=-0.077,P＜0.05)呈负相关,其中FBG与临床分期的相关系数最大.结论 胃癌患者大多数存在血液高凝状态和出血倾向,尤其以晚期胃癌显著,且随胃癌临床分期的增加,部分凝血指标出现增高趋势；临床上对凝血指标的变化监测可间接预示胃癌的发生、浸润和转移.
目的 探討胃癌患者術前外週血五項凝血指標與胃癌的臨床分期、胃癌轉移之間的相關性,以及不同臨床分期患者的凝血狀況及其臨床意義.方法 選擇首次診斷為胃癌的868例患者(胃癌組),併以同期住院的腹股溝疝患者213例作為對照組.觀察兩組患者術前外週血五項凝血指標:凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、纖維蛋白原(FBG)、血漿凝血酶時間(TT)和血小闆(PLT)計數,對其結果進行統計學分析.結果 (1)胃癌組與對照組比較,外週血血漿PT[ (11.51±1.21)s與(11.27 ±0.91)s,t=-3.226.P＜0.01]、FBG[(3010.0±470.4)mg/L與(2307.1±651.8)mg/L,t=-4.240,P＜0.01]、PLT計數[(238.57±78.50)x 109/L與(206.79±61.01)×109/L,t=-5.514,P＜0.01]明顯增高.(2)兩組外週血FBG差異具有統計學意義(p＜0.05)；血漿PT、PLT計數明顯增高,差異有統計學意義(P＜0.01)；胃癌組各臨床分期外週血APTT、TT和健康對照組相比,差異無統計學意義(P均＞0.05).(3)胃癌無轉移組與有轉移組相比,術前外週血PT[ (11.41±0.99)s與(11.57±1.32)s,t=-2.095,P＜0.05]延長、FBG含量[(2639.1±748.6)mg/L與(3233.2±591.60)mg/L,t=-2.307,P＜0.05]增加,PLT計數[(224.02±76.94)×109/L與(247.32±78.37)×109/L,t=-4.299,P＜0.01]顯著增加.(4)胃癌患者外週血五項凝血指標與臨床分期的相關分析,PT(r=0.071,P＜0.05)、FBG(r =0.271,P＜0.01)、PLT(r =0.166,P＜0.01)呈正相關,TT(r=-0.077,P＜0.05)呈負相關,其中FBG與臨床分期的相關繫數最大.結論 胃癌患者大多數存在血液高凝狀態和齣血傾嚮,尤其以晚期胃癌顯著,且隨胃癌臨床分期的增加,部分凝血指標齣現增高趨勢；臨床上對凝血指標的變化鑑測可間接預示胃癌的髮生、浸潤和轉移.
목적 탐토위암환자술전외주혈오항응혈지표여위암적림상분기、위암전이지간적상관성,이급불동림상분기환자적응혈상황급기림상의의.방법 선택수차진단위위암적868례환자(위암조),병이동기주원적복고구산환자213례작위대조조.관찰량조환자술전외주혈오항응혈지표:응혈매원시간(PT)、활화부분응혈활매시간(APTT)、섬유단백원(FBG)、혈장응혈매시간(TT)화혈소판(PLT)계수,대기결과진행통계학분석.결과 (1)위암조여대조조비교,외주혈혈장PT[ (11.51±1.21)s여(11.27 ±0.91)s,t=-3.226.P＜0.01]、FBG[(3010.0±470.4)mg/L여(2307.1±651.8)mg/L,t=-4.240,P＜0.01]、PLT계수[(238.57±78.50)x 109/L여(206.79±61.01)×109/L,t=-5.514,P＜0.01]명현증고.(2)량조외주혈FBG차이구유통계학의의(p＜0.05)；혈장PT、PLT계수명현증고,차이유통계학의의(P＜0.01)；위암조각림상분기외주혈APTT、TT화건강대조조상비,차이무통계학의의(P균＞0.05).(3)위암무전이조여유전이조상비,술전외주혈PT[ (11.41±0.99)s여(11.57±1.32)s,t=-2.095,P＜0.05]연장、FBG함량[(2639.1±748.6)mg/L여(3233.2±591.60)mg/L,t=-2.307,P＜0.05]증가,PLT계수[(224.02±76.94)×109/L여(247.32±78.37)×109/L,t=-4.299,P＜0.01]현저증가.(4)위암환자외주혈오항응혈지표여림상분기적상관분석,PT(r=0.071,P＜0.05)、FBG(r =0.271,P＜0.01)、PLT(r =0.166,P＜0.01)정정상관,TT(r=-0.077,P＜0.05)정부상관,기중FBG여림상분기적상관계수최대.결론 위암환자대다수존재혈액고응상태화출혈경향,우기이만기위암현저,차수위암림상분기적증가,부분응혈지표출현증고추세；림상상대응혈지표적변화감측가간접예시위암적발생、침윤화전이.
Objective To explore the relationship among the changes of five coagulation indexes and clinical stage,metastasis in pre-operative patients with gastric carcinoma,and to investigate the coagulation in patients with different clinical stages and its clinical significance.Methods Eight hundred and sixty-eight gastric carcinoma patients( carcinoma group) who were firstly diagnosed and 213 patients ( control group) who were diagnosed as inguinal hernia in the same hospital during the same period were enrolled.Levels of rothrombin time (PT),activated partial thromboplastin rime (APTT),fibrinogen (FBG),plasma thrombin time (TT) and platelet count (PLT)were observed and compared in these two groups.Results (1)Compared with health control group,PT( [ 11.51 ± 1.21 ] s vs [ 11.27 ± 0.91 ] s,t =- 3.226,P ＜ 0.01 ),FBG( [ 3010.0 ±470.4] mg/L vs [ 2307.1 ± 651.8 ] mg/L,t =- 4.240,P ＜ 0.01 ) and PLT ( 238.57 ± 78.50 ) x 109/L vs (206.79 ±61.01 ) x 109/L,t =-5.514,P ＜0.01 )were significantly increased in gastric carcinoma group.(2)PT,FBG and PLT were significantly different between control group and different clinical stages of gastric carcinoma group ( P ＜ 0.05 or P ＜ 0.01 ).The levels of APTF,TT exhibited no significant difference between control group and different clinical stages of gastric carcinoma group ( P ＞ 0.05 ).( 3 ) Compared with gastric carcinoma without metastasis group,preoperative blood PT extended significantly ([ 11.41 ± 0.99] s vs [ 11.57 ± 1.32 ]s,t =- 2.095,P ＜ 0.05 ),FBG concentration increased significantly ( [ 2639.1 ± 748.6 ] mg/Lvs [ 3233.2 ± 591.60 ] mg/L,t =- 2.307,P ＜ 0.05 ) and PLT count increased significantly ( [ 224.02 ±76.94] x 109/L vs [ 247.32 ± 78.37 ] x 109/L,t =- 4.299,P ＜ 0.01 ) in gastric carcinoma with metastasis group.(4) Correlation analysis on four coagulation and PLT count with clinical stage:PT ( r =0.071,P ＜ 0.05 ),FBG ( r =0.271,P ＜ 0.01 ) and PLT( r =0.166,P ＜ 0.01 ) were positively correlated with clinical stage of gastric carcinoma and TT( r =- 0.077,P ＜ 0.05 ) was negatively correlated with clinical stage,among the total,the correlation coefficient of FBS with clinical stage was maximum.Conclusion Most patients with gastric cancer present state of blood coagulation and bleeding tendency,particularly in advanced gastric cancer,and with increased clinical stage of gastric cancer,some coagulation indicators showing a rising trend.Detection of coagulation index indirectly indicates the incidence,invasion and metastasis of gastric carcinoma.
