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目的观察不同吸烟指数肺癌患者凝血指标的变化,探讨吸烟对肺癌患者凝血功能的影响。方法选取2010年7月至2015年7月间北京市朝阳区中医医院收治的130例肺癌患者。回顾性收集患者的临床资料,按照吸烟指数(每天吸烟支数×吸烟年数)分为4组,其中不吸烟者为0组(32例),吸烟指数<200支年为1组(30例),吸烟指数200~400支年为2组(33例),吸烟指数>400支年为3组(35例)。观察各组患者间凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)、血小板比容(PCT)、平均血小板体积(MPV)和血小板分布宽度(PDW)的水平,比较各组间的差异。结果随着吸烟指数的增加,PT和APTT均逐渐降低,FIB、D-D、PLT和PCT水平均逐渐升高,组间差异均有统计学意义(均P<0.05)。而MPV和PDW随吸烟指数的增加,组间均无明显变化,差异无统计学意义(P>0.05)。结论吸烟可导致肺癌患者PT和APTT明显降低,与吸烟指数呈明显负相关。吸烟可导致FIB、D-D和PLT明显升高,与吸烟指数呈明显正相关。随着吸烟指数的增加,肺癌患者的血液高凝状态逐渐加重。
Objective To observe the changes of coagulation index in patients with lung cancer with different smoking index and to explore the influence of smoking on the coagulation function in patients with lung cancer. Methods From July 2010 to July 2015, 130 cases of lung cancer patients were treated in Chaoyang District Chinese Medicine Hospital of Beijing. The clinical data of patients were retrospectively collected and divided into 4 groups according to the smoking index (number of cigarettes smoked per day × year of smoking), including 0 in non-smokers group (32 cases) and 1 in 30 smokers (<200 in smoking years) , Smoking index 200 ~ 400 years for two groups (33 cases), smoking index> 400 years for the three groups (35 cases). Prothrombin time (PT), activated partial thromboplastin time (APTT), FIB, DD, PLT and PCT ), Mean platelet volume (MPV) and platelet distribution width (PDW) were measured. The differences between groups were compared. Results With the increase of smoking index, both PT and APTT decreased gradually, and the levels of FIB, D-D, PLT and PCT increased gradually. There was significant difference between the two groups (all P <0.05). The MPV and PDW with smoking index increased, no significant changes between the groups, the difference was not statistically significant (P> 0.05). Conclusion Smoking can lead to significant reduction of PT and APTT in lung cancer patients, and negatively correlated with smoking index. Smoking can cause FIB, D-D and PLT significantly increased, and smoking index was positively correlated. With the increase of smoking index, the hypercoagulability state of lung cancer patients gradually aggravate.