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目的探讨晚期肺癌患者凝血、纤溶异常与血栓形成的相关性。方法检测95例晚期肺癌患者(肺癌组)及50例体检健康者(对照组)凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、血浆纤维蛋白原、D-二聚体水平及血小板计数,按不同病理类型及分期进行对比分析。结果肺癌组血清血浆纤维蛋白原为(6.0±1.1)g/L,血小板计数为(570.1±53.2)×109,D-二聚体为(1.3±0.3)mg/L,对照组分别为(2.9±0.5)g/L、(220.0±41.2)×109、(0.3±0.1)mg/L,2组比较差异有统计学意义(P<0.05);肺癌组活化部分凝血活酶时间((35.2±12.8)s)、凝血酶时间((12.8±0.7)s)、凝血酶原时间((12.1±1.2)s)与对照组((26.3±2.1)、(12.6±0.3)、(11.4±1.0)s)比较差异无统计学意义(P>0.05);小细胞癌、腺癌患者血浆纤维蛋白原((6.3±0.4)、(6.1±1.3)g/L)、D-二聚体((2.1±0.2)、(1.5±0.1)mg/L)高于鳞癌患者(5.6±1.5)g/L,(0.4±0.2)mg/L)(P<0.05);肺癌组不同临床分期患者血浆纤维蛋白原、D-二聚体、血小板计数比较差异无统计学意义(P>0.05)。结论晚期肺癌患者处于高凝、抗凝功能降低、继发纤溶亢进的状态,易导致血栓形成。
Objective To investigate the correlation between coagulation and fibrinolysis in patients with advanced lung cancer and thrombosis. Methods The serum levels of prothrombin time, activated partial thromboplastin time, thrombin time, plasma fibrinogen, D-dimer and platelets in 95 patients with advanced lung cancer (lung cancer group) and 50 healthy controls (control group) Count, according to different pathological types and staging comparative analysis. Results The serum level of fibrinogen in lung cancer group was (6.0 ± 1.1) g / L, the platelet count was (570.1 ± 53.2) × 109 and the D-dimer was (1.3 ± 0.3) mg / (P <0.05). The partial thromboplastin time in lung cancer group was (35.2 ± 0.5) g / L, (220.0 ± 41.2) × 109 and (0.3 ± 0.1) mg / 12.8 ± s), thrombin time (12.8 ± 0.7 s), prothrombin time (12.1 ± 1.2 s) and control group (26.3 ± 2.1), (12.6 ± 0.3) and (11.4 ± 1.0) s (P <0.05). The levels of fibrinogen (6.3 ± 0.4, 6.1 ± 1.3) g / L and ± 0.2) and (1.5 ± 0.1) mg / L, respectively, higher than that in squamous cell carcinoma (5.6 ± 1.5g / L, 0.4 ± 0.2mg / L) Protein, D-dimer, platelet count was no significant difference (P> 0.05). Conclusions In patients with advanced lung cancer, hypercoagulability, decreased anticoagulation, and secondary fibrinolysis may lead to thrombosis.