宫颈癌患者血栓弹力图与常规凝血试验的相关性研究

目的:利用血栓弹力图（thrombelastography，TEG）评价宫颈癌患者凝血状态，并探究其与常规凝血指标的相关性。方法:收集2016年4月至2017年10月期间到我院治疗宫颈癌患者60例为宫颈癌组，同时以健康女性30例作为对照组，所有研究对象均行TEG参数(R、K、Angel、MA、CI)、常规凝血试验(PT、APTT、Fib、D-D、FDP)以及血小板计数(PLT)检测。结果:宫颈癌组较对照组R、K显著缩短(P＜0.05)，Angel、MA、CI、Fib、D-D、FDP和PLT显著升高(P＜0.05)，差异具有统计学意义。PT、APTT在两者间无明显差异(P＞0.05)。相关性分析显示R与APTT，Angel与Fib，MA与PLT、Fib呈正相关（P＜0.05），R与D-D，K与Fib呈负相关（P＜0.05），差异均具有统计学意义。R与D-D的Kappa值是0.70（P＜0.001），二者具有中度一致性。通过ROC曲线我们发现，R为5.25 min时预测D-D升高大于0.5 μg/ml的敏感性是82.9%，特异性是89.5%。结论:宫颈癌患者血液呈高凝状态；TEG与特定的常规凝血参数之间显著相关；R和D-D具有检测的一致性。R值对宫颈癌患者D-二聚体水平的增高具有一定的敏感性和特异性。

To invetigate the correlations between thromboelastography and conventional coagulation tests in patients with cevical cancer

Objective:To investigate the coagulation state of cervical cancer patients by thrombelastography (TEG) and to investigate the correlations between TEG and conventional coagulation tests.Methods:Sixty patients with cervical cancer were teated in our hospital from April 2016 to October 2017 were as cervical cancer group.Besides,thrity healthy female subjects were served as control group.All subjects were examined with the parameters of TEG(R,K,Angel,MA,CI),conventional coagulation tests(PT,APTT,Fib,D-D,FDP) and platelet counts(PLT).Results:R value and K value in cervical cancer patients were significantly shorter than those in the controls(P＜0.05)，while the Angle,MA,CI,Fib,D-D,FDP and PLT were significantly higher in cervical cancer group(P＜0.05).There were no statistical difference in PT,APTT between the groups（P＞0.05）.Correlation analysis showed that there were significant positive correlations between R and APTT，between Angel and Fib，and between MA and PLT/Fib as well（P＜0.05）.There were significant negative correlations between R and D-D,between K and Fib（P＜0.05）.The Kappa values of the R with D-D was 0.70(P＜0.001).Through the ROC curve we found that the sensitivity to detect D-D above 0.5 μg/ml was 82.9% and the specificity was 89.5% when R is 5.25 minutes.Conclusion:Blood hypercoagulable state was found in patients with cervical cancer.There was significant correlations between the parameters of TEG and specific conventional coagulation tests.R and D-D have consistency in detection.R value has a certain sensitivity and specificity to predict elevated D-D levels in patients with cervical cancer.