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。
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 nostatistically 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（P0.01）; the differences in FIB, PLT, D-D among grade I–Ⅱ, Ⅲ and IV were all significantly different（P0.01）. 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.
作者
徐勇
张侠
XU Yong;ZHANG Xia(Graduate School, Anhui Medical University, Hefei 230032;Department of Oncology, Army General Hospital of PLA, Beijing 100700, China)
出处
《临床与病理杂志》
2018年第5期1020-1026,共7页
Journal of Clinical and Pathological Research
关键词
结直肠癌
高凝状态
凝血指标
转移
colorectal cancer
hypercoagulable state
coagulation index
metastasis
