凝血指标对非小细胞肺癌患者生存状况的影响研究

目的探讨凝血功能对非小细胞肺癌患者生存状况的影响及二者的相关性。方法选取2018年1月至2020年1月间上海市宝山区罗店医院收治的82例非小细胞肺癌患者,比较不同病理分期、淋巴结转移、远处转移情况下患者凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)和血小板(PLT)等凝血指标;比较不同指标下患者1年无瘤生存率;使用COX模型研究各凝血指标与患者生存状况的相关性。结果不同病理分期和不淋巴结转移患者的PT、APTT、FIB及D-D水平比较,差异均有统计学意义(均P <0.05)。其中病理分期Ⅲ~Ⅳ期的患者及N1~N3期淋巴结转移患者的PT、APTT、FIB和D-D水平均高于病理分期Ⅰ~Ⅱ期和N0期淋巴结转移患者。不同病理分期、淋巴结血管浸润、胸膜浸润、APTT、FIB及D-D的患者1年无瘤生存率比较,差异均有统计学意义(均P <0.05),其中病理分期Ⅲ~Ⅳ期、有淋巴结血管浸润、有胸膜浸润、APTT≤31.1s、FIB≤5.01和D-D≤2.21mg/L的患者1年无瘤生存率处于更低水平。APTT和FIB是影响非小细胞肺癌患者1年无瘤生存率的相关因素,APTT和FIB水平越高,患者生存率越低。结论凝血指标与非小细胞肺癌患者生存状况有明显相关性,APTT和FIB水平越高,患者生存率越低,可进行监测,以提高患者生存质量。

Effect of coagulation indexes on survival in patients with non-small cell lung cancer

Objective To explore the effect of coagulation function on the survival in patients with non-small cell lung cancer and the correlation between them. Methods A total of 82 patients with nonsmall cell lung cancer who received treatment at Luodian Hospital of Baoshan District were selected from January 2018 to January 2020. The blood coagulation indexes including prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D) and platelet(PLT) were compared among patients of different pathological stages,lymph node metastasis and distant metastasis. The 1-year tumor-free survival rate was compared among patients of different indexes. Logistics multivariate regression model was used to study the correlation between each coagulation index and the survival status. Results There were statistically significant differences in the levels of PT,APTT and FIB in patients of different pathological stages and lymph node metastasis. The levels of PT,APTT and FIB were higher in patients with pathological stage Ⅲ to Ⅳ cancer and N1 to N3 lymph node metastasis than in patients with pathological stage Ⅱ to Ⅱ cancer and N0 lymph node metastasis(all P < 0. 05). There were statistically significant differences in 1-year tumor-free survival rate among patients of different pathological stages,lymph node vascular invasion,pleural invasion,APTT,FIB and D-D(all P < 0. 05). Among them,1-year tumor-free survival was low in patients with pathological stage Ⅲ to Ⅳ cancer,central anatomy,pleural invasion,APTT > 31. 1 s,FIB > 5. 01 and D-D≤2. 21 mg/L(all P < 0. 05). APTT and FIB were related factors influencing 1-year tumor-free survival in patients with non-small cell lung cancer,and high APTT and FIB levels were associated with poor survival in this population. Conclusion Blood coagulation indexes were associated with survival in patients with non-small cell lung cancer. High APTT and FIB levels are associated with poor survival in this population.