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胃癌止血的一般变化

General changes in hemostasis in gastric cancer.

作者信息

Kovacova E, Kinova S, Duris I, Remkova A

机构信息

Ist Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia.

出版信息

Bratisl Lek Listy. 2009;110(4):215-21.

Abstract

Disorders of haemostasis and haemocoagulation are often seen in patients with cancer as a part of paraneoplastic syndrome. Thrombotic and/or haemorrhagic complications are the second most common cause of mortality in patients with cancer. The evaluation of the haemostatic parameters of 67 patients with gastric cancer have indicated tendency to thrombophilia and activation of intravascular coagulation, of which 31.3% showed tendency to hypercoagulation and 47.8% disseminated intravascular coagulation (DIC). Only 7.5% of subjects have yielded normal laboratory findings while 5.9% of patients had DIC with remarkable hypocoagulation. Thrombocytosis, platelet hyperaggregability and elevation of beta-thromboglobulin are the indicators of changes in primary haemostasis and elevation of thrombomodulin indicates vascular wall damage. Lower antithrombin III levels, C-protein and S-protein in plasma have indicated lower antithrombotic potential in patients with gastric cancer. It can be concluded that patients suffering from gastric cancer are at higher risk of thromboembolism as for haemorrhagic diathesis (20.1% thromboembolism, 11.94% fatal thromboembolic events vs 5.9 % haemorrhagic diathesis) (Tab. 5, Ref. 22). Full Text (Free, PDF) www.bmj.sk.

摘要

止血和血液凝固紊乱在癌症患者中常作为副肿瘤综合征的一部分出现。血栓形成和/或出血并发症是癌症患者第二常见的死亡原因。对67例胃癌患者止血参数的评估表明存在血栓形成倾向和血管内凝血激活,其中31.3%表现为高凝倾向,47.8%表现为弥散性血管内凝血(DIC)。只有7.5%的受试者实验室检查结果正常,而5.9%的患者患有伴有明显低凝的DIC。血小板增多、血小板高聚集性和β-血小板球蛋白升高是原发性止血变化的指标,而血栓调节蛋白升高表明血管壁受损。血浆中抗凝血酶III水平、C蛋白和S蛋白降低表明胃癌患者的抗血栓形成潜力较低。可以得出结论,胃癌患者发生血栓栓塞的风险较高,而出血素质的风险较低(20.1%的血栓栓塞,11.94%的致命性血栓栓塞事件,而出血素质为5.9%)(表5,参考文献22)。全文(免费,PDF)www.bmj.sk

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