Fu Yang, Liu Yumei, Jin Yaxiong, Jiang Hong
Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhongguo Fei Ai Za Zhi. 2018 Aug 20;21(8):583-587. doi: 10.3779/j.issn.1009-3419.2018.08.03.
Coagulation and fibrinolysis biomarkers can effectively reflect the dysfunction of coagulation and anticoagulation system, and the changes of their levels were closely related to the hypercoagulable status. The aim of this study is to study the variation tendency of these coagulation and fibrinolysis markers and explore the diagnosis power and clinical value of these biomarker for thrombosis in postoperative lung cancer patients with deep vein catheterization.
We selected 118 postoperative lung cancer patients with deep vein catheterization including 29 patients with thromboembolism and 89 patients in control group. Coagulation and fibrinolysis parameters [thrombomodulin (TM)/thrombin-antithrombin complex (TAT)/α2-plasmin inhibitor-plasmin complexes (PIC)/tissue plasminogen activator-inhibitor complexes (t-PAIC)] and traditional coagulation time[prothrombintime (PT)/activated partial thrombo plastin time(APTT)/thrombintime (TT)/fibrinogen (FIB)/antithrombin III (ATIII)/fibrinogen degradation products (FDP)/D-Dimer (D-D)] were detected in both groups. We analyzed the variation tendency of these biomarkers and figured out the diagnosis powerfor thrombosis.
A statistically significant difference was available on the value of TM, TAT, PIC, t-PAIC, D-D, FDP between thrombosis group and non-thrombosis group (P<0.05). TM, TAT, PIC, t-PAIC, D-D, FDP performed with an AUC of 0.770, 0.771, 0.669, 0.671, 0.819, 0.816, respectively (P<0.05).
An enhanced coagulation and fibrinolysis activity existed in lung cancer patients with deep vein catheterization after surgery, and early detection of coagulation and fibrinolytic biomarkers could prevent thrombosis and reduce postoperative thrombosis complications in patients with lung cancer.
凝血和纤溶生物标志物能有效反映凝血和抗凝系统功能障碍，其水平变化与高凝状态密切相关。本研究旨在探讨这些凝血和纤溶标志物的变化趋势，探索其对术后肺癌深静脉置管患者血栓形成的诊断效能及临床价值。
选取118例术后肺癌深静脉置管患者，其中血栓栓塞患者29例为血栓组，89例为对照组。检测两组凝血和纤溶参数[血栓调节蛋白（TM）/凝血酶 - 抗凝血酶复合物（TAT）/α2 - 纤溶酶抑制物 - 纤溶酶复合物（PIC）/组织纤溶酶原激活物 - 抑制物复合物（t - PAIC）]及传统凝血时间[凝血酶原时间（PT）/活化部分凝血活酶时间（APTT）/凝血酶时间（TT）/纤维蛋白原（FIB）/抗凝血酶III（ATIII）/纤维蛋白原降解产物（FDP）/D - 二聚体（D - D）]。分析这些生物标志物的变化趋势，计算其对血栓形成的诊断效能。
血栓组与非血栓组在TM、TAT、PIC、t - PAIC、D - D、FDP值上存在统计学差异（P<0.05）。TM、TAT、PIC、t - PAIC、D - D、FDP的曲线下面积（AUC）分别为0.770、0.771、0.669、0.671、0.819、0.816（P<0.05）。
术后肺癌深静脉置管患者存在凝血和纤溶活性增强，早期检测凝血和纤溶生物标志物可预防肺癌患者血栓形成并减少术后血栓并发症。
