肺癌患者化疗前后凝血、纤溶功能与血小板参数的变化及其临床意义

目的探讨肺癌患者化疗前后凝血、纤溶功能相关指标与血小板参数的变化及其临床意义。方法检测60例肺癌患者化疗前后血浆凝血酶原时间(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)、血浆蛋白C(PC)、游离蛋白S(FPS)、纤溶酶原激活剂抑制物-Ⅰ(PAI-Ⅰ)、血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW),并以20例健康体检者作为正常对照。结果肺癌患者化疗前与正常对照相比,血浆FIB、D-D、PAI-Ⅰ含量明显升高(P<0.05或P<0.01),血浆PC、FPS含量明显降低(P<0.05),PLT、PCT、MPV明显升高(P<0.05);肺癌患者化疗后与化疗前相比,血浆PT、TT、APTT明显缩短(P<0.01),血浆FIB、D-D含量降低(P<0.05或P<0.01)、PAI-Ⅰ含量升高(P<0.01),PC、FPS含量降低(P<0.05),PLT、PCT、MPV下降(P<0.01);肺癌患者化疗前后的凝血、纤溶功能相关指标和血小板参数与患者性别、病理类型、TNM分期、有无转移等临床病理特征之间无显著关联(P>0.05)。结论肺癌患者化疗前凝血、纤溶功能和血小板各项指标明显不同于正常人,总体处于高凝、抗凝功能降低、继发纤溶亢进的状态下,化疗可进一步加剧肺癌患者的凝血功能紊乱。

Dynamic changes and clinical significance of coagulation,fibrinolytic function and platelet parameter before and after chemotherapy in lung cancer patients

Objective To evaluate the dynamic changes and clinical significance of coagulation,fibrinolytic markers and platelet parameters before and after chemotherapy in lung cancer patients.Methods The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D),protein C(PC),free protein S(FPS),plasminogen activator inhibitor-Ⅰ(PAI-Ⅰ),platelet total(PLT),plateletcrit(PCT),mean platelet volume(MPV) and platelet distribution width(PDW) were measured in sixty lung cancer patients before and after chemotherapy,with twenty healthy people as control.Results Compared with the control group,the mean value of FIB,D-D,PAI-Ⅰ,PLT,PCT and MPV were significantly increased(P<0.05 or P<0.01) in patients with lung cancer while the mean value of PC and FPS was decreased(P<0.05).Compared with the pre-treatment patients,the mean value of PT,TT,APTT,FIB,D-D,PC,FPS,PLT,PCT and MPV was significantly decreased(P<0.05 or P<0.01) in post-treatment patients.However,the mean value of PAI-Ⅰ was increased(P<0.01).There existed no relationship between the plasma level of coagulation,fibrinolytic markers,platelet parameters,sex,histological classification,TNM stages,and metastasis in lung cancer patients before or after chemotherapy(P>0.05).Conclusion The state of hypercoagulability,secondary hyperfibrinolysis and low anticoagulation occur among patients with lung cancer.Chemotherapy may enhance blood coagulation functional disorders.