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目的探讨外周血凝血指标与胃癌临床病理特征及化疗的相关性。方法选择2013年2月至2015年12月延安大学附属医院普通外科收治的120例胃癌患者作为观察组,另选100例健康人作为对照组,比较两组的凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、血清纤维蛋白原(FIB)、血小板计数(PLT)和D-二聚体(D-D)等外周血凝血指标,并比较不同临床病理特征胃癌患者的外周血凝血指标。结果两组APTT和PT比较无统计学意义(P>0.05),观察组TT显著低于对照组(P<0.05),FIB、D-D和PLT均显著高于对照组(P<0.01)。胃癌患者中,男性TT及PLT均显著低于女性(P<0.05),年轻患者FIB和D-D显著低于老年患者(P<0.05),肿瘤侵袭较浅者FIB及PLT显著低于侵袭较深者(P<0.01),分期较低者PT、FIB、D-D和PLT显著低于分期较高者(P<0.01),分化较低者TT显著低于分化较高者(P<0.05),PLT显著高于分化较高者(P<0.05),无转移者D-D与PLT均显著低于有转移者(P<0.05);化疗后胃癌患者FIB及PLT均显著降低(P<0.01)。结论胃癌患者血液呈高凝状态,且女性、老年、肿瘤侵犯较深、分期较高、分化较低和存在转移的患者更为严重,监测外周血凝血指标,能够较早了解凝血功能异常及出血倾向,及早给予科学干预具有重要临床价值。
Objective To investigate the correlation between peripheral blood coagulation index and clinicopathological characteristics and chemotherapy in gastric cancer. Methods A total of 120 patients with gastric cancer admitted from General Surgery Hospital of Yan’an University from February 2013 to December 2015 were selected as observation group and another 100 healthy people as control group. Thrombin time (TT), activation Thromboplastin time (APTT), prothrombin time (PT), serum fibrinogen (FIB), platelet count (PLT) and D-dimer (DD) were measured and compared with different clinicopathological features Peripheral blood coagulation index in patients with gastric cancer. Results There was no significant difference in APTT and PT between the two groups (P> 0.05). TT in the observation group was significantly lower than that in the control group (P <0.05). FIB, D-D and PLT were significantly higher than those in the control group (P <0.01). The levels of TT and PLT in male patients were significantly lower than those in female patients (P <0.05). The FIB and DD in young patients were significantly lower than those in elderly patients (P <0.05). The FIB and PLT in patients with gastric cancer were significantly lower than those in patients with aggressive tumors (P <0.01). The levels of PT, FIB, DD and PLT in the lower staging group were significantly lower than those in the higher staging group (P <0.01), and those with lower differentiation were significantly lower than those with higher differentiation (P <0.05). The DD and PLT of patients without metastasis were significantly lower than those with metastasis (P <0.05). The FIB and PLT of gastric cancer patients after chemotherapy were significantly decreased (P <0.01). Conclusion The blood of patients with gastric cancer showed hypercoagulable state, and the invasion of female, elderly and tumor was deeper, the stage was higher, the differentiation was lower and the patients with metastasis were more serious. Monitoring peripheral blood coagulation index could understand coagulation dysfunction and hemorrhage earlier Tendency to give scientific intervention early has important clinical value.