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凝血指标及炎症变化与肺癌合并血栓栓塞性疾病预后的相关性

Correlations of coagulation indexes and inflammatory changes with the prognosis of lung cancer complicated with thromboembolic disease.

作者信息

Zhu Minfeng, Dai Yi, Gao Feng, Xu Chunming, Chen Lixiu, Xu Yun, Qian Wenxia

机构信息

Department of Respiratory, The First People Hospital of Zhangjiagang City, Soochow University, Zhangjiagang, China.

出版信息

J BUON. 2019 Mar-Apr;24(2):585-590.

Abstract

PURPOSE

To investigate the correlations of coagulation indexes and inflammatory changes with the prognosis of lung cancer (LC) patients complicated with thromboembolic (TE) disease.

METHODS

A total of 84 LC patients complicated with TE disease admitted to hospital from January 2010 to January 2016 were enrolled in this study and their clinical data were retrospectively analyzed. A 2-year post-treatment follow-up was carried out. According to the prognosis, patients were divided into 2 groups as dead group (n=25) and alive group (n=59). The coagulation indexes and inflammatory factor levels before low-molecular weight heparin (LMWH) treatment and on the 1st, 3rd, and 7th day after treatment were compared between the two groups. Their relations with the prognosis of patients were analyzed using Pearson method.

RESULTS

No statistically significant difference was found in the prothrombin time (PT), levels of Fibrinogen (FIB), D-Dimer (D-D), Interleukin-6 (IL-6) and Procalcitonin (PCT), and activated partial thromboplastin time (APTT) before treatment between the two groups (p>0.05). The PT and levels of FIB, D-D, IL-6, and PCT on the 1st, 3rd, and 7th day after treatment were significantly increased in the dead group compared to those in the alive group, while the APTT was remarkably shortened. Moreover, the PT was gradually prolonged and FIB, D-D, IL-6 and PCT levels were increased in the dead group , but the APTT was gradually shortened over time (p<0.05). The poor prognosis of LC patients complicated with TE disease was positively correlated with PT, FIB, D-D, IL-6 and PCT, but negatively correlated with APTT (p<0.05).

CONCLUSION

The poor prognosis of LC complicated with TE disease has positive correlations with PT, FIB, D-D, IL-6 and PCT, and a negative association with APTT, providing a certain reference as a prognostic value in the diagnosis and treatment.

摘要

目的

探讨凝血指标及炎症变化与合并血栓栓塞(TE)疾病的肺癌(LC)患者预后的相关性。

方法

选取2010年1月至2016年1月期间收治的84例合并TE疾病的LC患者,对其临床资料进行回顾性分析。进行为期2年的治疗后随访。根据预后情况,将患者分为死亡组(n = 25)和存活组(n = 59)。比较两组患者在低分子肝素(LMWH)治疗前及治疗后第1、3、7天的凝血指标和炎症因子水平。采用Pearson法分析它们与患者预后的关系。

结果

两组患者治疗前的凝血酶原时间(PT)、纤维蛋白原(FIB)、D - 二聚体(D - D)、白细胞介素 - 6(IL - 6)、降钙素原(PCT)水平及活化部分凝血活酶时间(APTT)比较,差异无统计学意义(p > 0.05)。与存活组相比,死亡组治疗后第1、3、7天的PT及FIB、D - D、IL - 6、PCT水平显著升高,而APTT明显缩短。此外,死亡组PT逐渐延长,FIB、D - D、IL - 6和PCT水平升高,但APTT随时间逐渐缩短(p < 0.05)。合并TE疾病的LC患者预后不良与PT、FIB、D - D、IL - 6和PCT呈正相关,与APTT呈负相关(p < 0.05)。

结论

合并TE疾病的LC患者预后不良与PT、FIB、D - D、IL - 6和PCT呈正相关,与APTT呈负相关,可为诊断和治疗中的预后评估提供一定参考。

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