Quan Xuemei, Qin Qixiong, Que Xianting, Chen Ya, Wei Yunfei, Chen Hao, Li Qianqian, Meng Chaoguo, Liang Zhijian
Department of Neurology, 117742The First Affiliated Hospital of Guangxi Medical University, Nanning Guangxi Province, China.
Department of Neurology, 117742The Third Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, China.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620975502. doi: 10.1177/1076029620975502.
Lung cancer related hypercoagulability could increase the risk of ischemic stroke. Routine coagulation tests may have limited capacity in evaluating hypercoagulability. The aim of this study was to investigate the ability of thromboelastography (TEG) in the identification of hypercoagulability in patients with lung cancer and cryptogenic ischemic stroke (LCIS). Between January 2016 and December 2018, whole citrated blood from LCIS patients (n = 35) and age- and gender-matched lung cancer patients and healthy volunteers were used for TEG and routine coagulation tests. The coagulation indicator and clinical data were compared among the 3 groups. There were 27/35 (77.14%) on TEG and 18/35 (51.43%) on routine coagulation tests of LCIS patients who had evidence of hypercoagulability. The detection rate of hypercoagulability by TEG in LCIS patients was higher than routine coagulation tests ( = 0.018). Comparing with lung cancer patients and healthy controls, LCIS patients have a significantly higher maximum amplitude (MA), fibrinogen, and D-dimer. Multivariate analysis showed that D-dimer and MA were significantly associated with ischemic stroke in lung cancer patients. ROC curve showed that the area under the curve of TEG (0.790 ± 0.048, 95% CI: 0.697-0.864) was significantly higher than routine coagulation tests (0.673 ± 0.059, 95% CI: 0.572-0.763) ( = 0.04) in identifying hypercoagulability in LCIS patients. Therefore, TEG could identify hypercoagulability in LCIS patients and healthy controls. Identification of hypercoagulability in lung cancer patients by TEG may be helpful to prevent the occurrence of LCIS.
肺癌相关的高凝状态可能会增加缺血性中风的风险。常规凝血检测在评估高凝状态方面的能力可能有限。本研究的目的是探讨血栓弹力图（TEG）在识别肺癌合并隐源性缺血性中风（LCIS）患者高凝状态方面的能力。2016年1月至2018年12月期间，将LCIS患者（n = 35）以及年龄和性别匹配的肺癌患者和健康志愿者的全枸橼酸盐血用于TEG和常规凝血检测。比较三组的凝血指标和临床数据。LCIS患者中，TEG检测显示有高凝状态证据的占27/35（77.14%），常规凝血检测显示有高凝状态证据的占18/35（51.43%）。LCIS患者中TEG检测高凝状态的发生率高于常规凝血检测（P = 0.018）。与肺癌患者和健康对照相比，LCIS患者的最大振幅（MA）、纤维蛋白原和D - 二聚体显著更高。多因素分析显示，D - 二聚体和MA与肺癌患者的缺血性中风显著相关。ROC曲线显示，在识别LCIS患者的高凝状态方面，TEG的曲线下面积（0.790±0.048，95%CI：0.697 - 0.864）显著高于常规凝血检测（0.673±0.059，95%CI：0.572 - 0.763）（P = 0.04）。因此，TEG可以识别LCIS患者和健康对照中的高凝状态。通过TEG识别肺癌患者的高凝状态可能有助于预防LCIS的发生。
