不同阶段胃癌患者高凝状态相关指标的变化及意义

目的探讨不同阶段胃癌患者高凝状态相关指标变化的意义以及低白蛋白血症对高凝状态的影响。方法回顾性分析94例胃癌患者的临床资料,根据CT及病理结果将94例胃癌患者分为未转移组(23例)、淋巴结转移组(48例)和远处转移组(23例),测定其血小板(PLT)、纤维蛋白原(FIB)及白蛋白(ALB)水平,与对照组(31例健康体检者)进行比较,并分析胃癌患者FIB与ALB的相关性。结果未转移组、淋巴结转移组和远处转移组胃癌患者PLT、FIB水平均显著高于对照组,ALB水平显著低于对照组,差异均有统计学意义(P均<0.05)。远处转移组比未转移组PLT、FIB显著升高,而ALB显著降低,差异均有统计学意义(P均<0.05)。远处转移组与淋巴结转移组相比,FIB显著增高,而ALB显著降低,差异均有统计学意义(P均<0.05)。胃癌患者中,ALB与FIB呈显著负相关(r=-0.311,P=0.002)。结论胃癌患者存在高凝状态,且随远处转移的发生高凝状态更为显著,伴随低白蛋白血症者高凝状态也更为明显。

The Change of Hypercoagulable State in Patients with Gastric Cancer of Different Periods and Its Clinical Significance

Objective To study the change of hypercoagulable state of the patients with gastric cancer of different periods,and to analyze the effect of hypoalbuminemia on hypercoagulable state. Methods The clinical data of 94 patients with gastric cancer were analyzed retrospectively.According to the results of pathology and CT,the 94 patients with gastric cancer were classified into the none metastasis group(23 cases),the lymph node metastasis group(48 cases) and the distant metastasis group(23cases).The 31 healthy subjects served as normal controls.The levels of platelet count(PLT),fibrinogen(FIB) and albumin(ALB) were determined.The correlation between FIB and ALB was analyzed. Results The levels of PLT and FIB of the none metastasis group,the lymph node metastasis group and the distant metastasis group were significantly higher than those of the normal controls,and the levels of ALB were significantly lower(P<0.05).The levels of PLT and FIB of the distant metastasis group were significantly higher than those of the none metastasis group,and the levels of ALB were significantly lower(P<0.05).The level of FIB of the distant metastasis group was significantly higher than that of the lymph node metastasis group,and that of ALB was significantly lower(P<0.05).In all the patients with gastric cancer,ALB was negatively correlated with FIB(r=-0.311,P=0.002). Conclusion The patients with gastric cancer have a hypercoagulable state,and it becomes more obvious accompanied with distant metastasis.Hypercoagulable state is also more obvious in the patients with hypoalbuminemia.