检验医学 ›› 2014, Vol. 29 ›› Issue (10): 995-999.DOI: 10.3969/j.issn.1673-8640.2014.10.003

• 临床应用研究·论著 • 上一篇    下一篇

蛋白C、抗凝血酶及凝血因子Ⅷ活性变化与肺癌合并肺栓塞后治疗的关系

陈环1, 张鹏1, 刘军锋2   

  1. 1.天津医科大学肿瘤医院检验科 国家肿瘤临床医学研究中心 天津市肿瘤防治重点实验室,天津 300060;
    2.天津泰达国际心血管病医院 天津医科大学心血管病临床学院检验科,天津 300457
  • 收稿日期:2014-06-04 出版日期:2014-10-30 发布日期:2014-10-22
  • 通讯作者: 张 鹏,联系电话:022-23340123;刘军锋,联系电话:022-65208763。
  • 作者简介:陈 环,女,1978年生,学士,主管技师,主要从事临床检验及肿瘤相关研究工作。

Correlation of the activities of protein C, antithrombin and coagulation factor Ⅷ with the treatment of lung cancer with pulmonary embolism

CHEN Huan1, ZHANG Peng1, LIU Junfeng   

  1. 1. Department of Clinical Laboratory, Cancer Hospital, Tianjin Medical University; National Clinical Rsearch Center of Cancer; Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060,China;
    2. TEDA International Cardiovascular Hospital; Department of Clinical Laboratory, Cardiovascular Disease Clinical College, Tianjin Medical University, Tianjin 300457,China
  • Received:2014-06-04 Online:2014-10-30 Published:2014-10-22

摘要:

目的 探讨蛋白C(PC)、抗凝血酶(AT)及凝血因子Ⅷ(FⅧ)活性变化与肺癌合并肺血栓栓塞[简称肺栓塞(PE)]后治疗的关系。方法 选择肺癌合并PE患者(肺癌+PE组)98例及肺癌患者(肺癌组)100例。记录两组性别、年龄并检测脂蛋白(a)[Lp(a)]、总胆固醇(TC)、甘油三酯(TG)、C反应蛋白(CRP)、凝血酶时间(TT)、血小板数量(PLT)、纤维蛋白原(Fbg)等指标。检测肺癌+PE组治疗5~7 d及肺癌组入院时的PC、AT、FⅧ、D-二聚体水平。应用Logistic回归分析肺癌合并PE后治疗5~7 d凝血-纤溶状态的影响因素,并采用受试者工作特征(ROC)曲线分析影响因素的诊断效能。结果 肺癌+PE组Lp(a)、TC、TG、TT均明显高于肺癌组(P<0.05)。肺癌+PE组PC、AT、FⅧ、D-二聚体水平明显高于肺癌组(P<0.01)。Logistic逐步回归及ROC曲线分析显示,PC、AT、FⅧ是肺癌合并PE后治疗5~7 d凝血-纤溶状态的影响因素,ROC曲线下面积均>0.90。结论 肺癌合并PE中期治疗需关注PC、AT、FⅧ对凝血-纤溶系统的影响,其活性水平可用来评估一定时期内的治疗效果和治疗方案。

关键词: 蛋白质C, 抗凝血酶, 凝血因子&, #x02167, 肺癌, 肺血栓栓塞

Abstract:

Objective To investigate the correlation of the activities of protein C(PC), antithrombin(AT) and coagulation factor Ⅷ(FⅧ) with the treatment of lung cancer with pulmonary embolism(PE). Methods A total of 98 patients with lung cancer and PE were enrolled as lung cancer with PE group. A total of 100 patients with lung cancer were enrolled as lung cancer group. Their sex and age were recorded, and lipoprotein(a)[Lp(a)], total cholesterol(TC), triglyceride (TG), C-reactive protein(CRP), thrombin time(TT), platelet (PLT) and fibrinogen(Fbg)in the 2 groups were determined, respectively. PC, AT, FⅧ and D-dimer were determined in lung cancer with PE group after 5-7 d of treatment. Logistic regression analysis was used to analyze the factors influencing coagulation-fibrinolysis after 5-7 d of treatment in lung cancer with PE group. The receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficiency of these factors. Resutls Lp(a), TC, TG and TT in lung cancer with PE group were significantly higher than those in lung cancer group (P<0.05). The levels of PC, AT, FⅧ and D-dimer were significantly higher in lung cancer with PE group than those in lung cancer group (P<0.01).Logistic regression analysis and ROC curve analysis showed that PC, AT and FⅧ were influencing factors of coagulation-fibrinolysis after 5-7 d of treatment in lung cancer with PE group, and the areas under ROC curve were >0.90. Conclusions The influence of PC, AT and FⅧ on coagulation-fibrinolysis should be concerned in midterm treatment of lung cancer with PE, and their activities can be used to assess the therapeutic efficiency and treatment program in a given period.

Key words: Protein C, Antithrombin, Coagulation factor &, #x02167, Lung cancer, Pulmonary embolism

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