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目的:探讨肾癌患者异常增高的凝血指标、静脉血栓栓塞症(VTE)发生率与临床分期的关系,分析肾癌患者血液高凝状态的临床特征。方法:对2010年至2012年335例住院的肾癌患者Fib、D-D、BPC水平进行检测并筛查发生VTE的患者。结果:335例肾癌患者中,异常Fib、D-D、BPC的发生率分别为20.6%、9.9%、6.6%,且随着肾癌分期的增加,凝血指标异常的发生率逐渐升高,各分期之间比较有统计学差异(P<0.05);VTE的发生率为2.2%,Ⅳ期肾癌患者最高为1.2%,且各分期之间比较有统计学意义(P<0.05)。年龄≥60岁、肿瘤最大径>10 cm、临床分期晚、伴有远处转移的肾癌患者血液高凝的发生率分别显著高于年龄<60岁、肿瘤最大径<10 cm、临床分期早、不伴有远处转移的肾癌患者(P<0.05)。结论:年龄≥60岁、肿瘤最大径>10 cm、临床分期晚、伴有远处转移可能是肾癌患者发生血液高凝状态和VTE的危险因素,应引起临床重视。
Objective: To investigate the abnormally elevated coagulation index, the incidence of venous thromboembolism (VTE) and the clinical stage in patients with renal cell carcinoma, and to analyze the clinical features of blood hypercoagulability in patients with renal cell carcinoma. Methods: The levels of Fib, D-D and BPC in 335 hospitalized patients with renal cell carcinoma from 2010 to 2012 were measured and the patients with VTE were screened. Results: The incidences of abnormal Fib, DD and BPC in 335 cases of renal cell carcinoma were 20.6%, 9.9% and 6.6%, respectively. The incidence of abnormal coagulation index gradually increased with the increase of stage of renal cell carcinoma. (P <0.05). The incidence of VTE was 2.2%, and the highest in stage Ⅳ renal cell carcinoma was 1.2%. There was a significant difference between each stage (P <0.05). The incidence of hypercoagulability in patients with renal cell carcinoma with distant metastasis was significantly higher than that of patients younger than 60 years old and the largest diameter of tumor less than 10 cm , Not associated with distant metastasis of renal cell carcinoma patients (P <0.05). CONCLUSIONS: Aged ≥60 years old and the largest diameter of tumor> 10 cm, late clinical stage with distant metastasis may be the risk factor of blood hypercoagulability state and VTE in patients with renal cell carcinoma, which should be clinically valued.