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1、晚期非小细胞肺癌患者凝血指标的临床分析作者：杨国旺,富琦,徐咏梅,高珊,张青,赵文硕,王笑民【摘要】目的探讨晚期非小细胞肺癌(NSCLC)患者凝血指标分布特点及与患者预后、中医证型和远期血栓性事件的相关性。方法选取住院治疗的NSCLC患者进行回顾性调查,对其凝血指标应用SPSS13.0软件进行数据分析。结果非晚期组患者出现1项和1项以上凝血指标异常的分别有10例(38.5%)和8例(30.8%),而晚期组NSCLC患者分别为95例(71.4%)和77例(57.9%),组间差异有统计学意义(P＜0.05)；血浆纤维蛋白原(FIB)、
2、D-二聚体(D-dimer)的水平在晚期组和非晚期组患者中有显著差别。凝血指标中FIB和D-dimer的数值与晚期NSCLC患者的生存期成负相关(P＜0.05)。FIB水平和气虚证关系密切(P＜0.05)。血瘀证、气滞证与血凝状态关系密切,但只有前者有统计学意义(P＜0.05)。晚期组血栓性不良事件发生率较非晚期组为高。结论晚期NSCLC患者普遍存在凝血功能异常,并且与不良预后密切相关,初步提示益气活血法可以作为中医药对凝血功能异常状态进行有效干预的方向之一。【关键词】非小细胞肺癌；凝血指标；血栓性事件；中医证型 Abstrac
3、t：ObjectiveTodiscussthedistributionofcoagulationmarkersinpatientswithadvancednon-smallcelllungcancer(NSCLC)andthecorrelationofthesemarkerswiththeprognosisofthepatients,theTCMsyndromeandthelong-termthromboticevents.MethodHospitalizedNSCLCpatientswereselectedforretrospe
4、ctiveinvestigationandthecoagulationmarkersdatawereanalyzedwithSPSS13.0.ResultTherewere10cases(38.5%)andeightcases(30.8%)withoneormoreabnormalcoagulationmarkersinthenon-advancedNSCLCgroup,whiletherewere95cases(71.4%)and77cases(57.9%)intheadvancedNSCLCgroup.Thereweresig
5、nificantdifferencebetweenthetwogroups(P＜0.05).FIBandD-dimerlevelsshowedsignificantdifferencebetweentheadvancedNSCLCgroupandthenon-advancedNSCLCgroupaswell.TherewasnegativecorrelationbetweenthevaluesofFIBandD-dimerwiththesurvivalperiodofadvancedNSCLCpatients(P＜0.05).FI
6、Blevelwascloselyrelatedtotheqideficiencysyndrome(P＜0.05).Bloodstasissyndromeandgasstagnationsyndromewerecloselyrelatedtoprothromboticstate,butonlytheformershowedsignificantdifferencestatistically(P＜0.05).TheincidenceofadversethromboticeventswashigherintheadvancedNSCLC
7、groupthaninthenon-advancedNSCLCgroup.ConclusionCoagulationdisorderiscommonamongadvancedNSCLCpatients,whichiscloselyrelatedtopoorprognosis.ItisindicatedthatthemethodofbenefitingvitalenergyandpromotingbloodcanbeusedasoneofeffectiveTCMinterventionsinthetreatmentofcoagula
8、tiondisorder. Keywords：non-smallcelllungcancer；coagulationmarkers；adversethromboticevents；TCMsyndrome国内外多项研究结果表明,恶性肿瘤特别是晚期肿
