[1]刁 雪,彭兰欢,曾婷婷,等.血细胞计数和D-二聚体检测 在肺癌并发血栓患者中的变化研究[J].现代检验医学杂志,2015,30(01):68-71.[doi:10.3969/j.issn.1671-7414.2015.01.018]
　DIAO Xue,PENG Lan-huan,ZENG Ting-ting,et al.Analysis of the Changes of Blood Cell Count and D-dimer in Lung Cancer Patients with Thrombosis[J].Journal of Modern Laboratory Medicine,2015,30(01):68-71.[doi:10.3969/j.issn.1671-7414.2015.01.018]
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血细胞计数和D-二聚体检测 在肺癌并发血栓患者中的变化研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第30卷
期数:
2015年01期
页码:
68-71
栏目:
论著
出版日期:
2015-01-30

文章信息/Info

Title:
Analysis of the Changes of Blood Cell Count and D-dimer in Lung Cancer Patients with Thrombosis
文章编号:
1671-7414(2015)01-068-04
作者:
刁 雪; 彭兰欢; 曾婷婷; 周 静; 粟 军
四川大学华西医院,成都 610041
Author(s):
DIAO Xue; PENG Lan-huan; ZENG Ting-ting; ZHOU Jing; SU Jun
West China Hospital of Sichuan University,Chengdu 610041,China
关键词:
血细胞计数;  D-二聚体;  肺癌;  血栓
分类号:
R734.3; R730.43
DOI:
10.3969/j.issn.1671-7414.2015.01.018
文献标志码:
A
摘要:
目的 探讨肺癌并发血栓患者的血细胞计数和D-二聚体的变化及其对肺癌患者并发血栓的诊断作用。方法 ①选取2012年1月～2013年11月间554例肺癌患者,排除75例其他导致高凝状态疾病的患者,对64例病例组肺癌并发血栓患者与415例对照组肺癌未并发血栓患者的血细胞计数和D-二聚体进行比较。②以血管彩超作为诊断血栓的金标准,对方法1中t检验有统计学意义的指标绘制受试者工作特性曲线(receiver operating characteristic curve,ROC曲线)。结果 ①肺癌并发血栓患者红细胞计数(red blood cell count,RBC)显著降低、白细胞计数(white blood cell count,WBC)显著增高、D-二聚体含量显著增高、而血小板计数(platelet cell count, PLT)无明显变化。②RBC的ROC曲线下面积(area under the curve,AUC)为0.662,Kappa=0.128; WBC的ROC AUC=0.637,Kappa=0.110; D-二聚体的ROC AUC=0.896,Kappa=0.668。以RBC>4.06×1012/L,WBC<5.37×109/L,D-二聚体<4.02 mg/L对肺癌患者是否并发血栓的阴性预测值分别为93%,93%,96%; 以D-二聚体>4.02 mg/L诊断肿瘤患者是否并发血栓阳性预测值为66%。结论 对RBC,WBC和D二聚体的测定可以反应肺癌患者血栓的发生发展; RBC,WBC和D-二聚体对肺癌患者是否并发血栓有很好的阴性预测作用; D-二聚体对肿瘤患者是否并发血栓有一定的阳性预测作用。
Abstract:
Objective To analyze the changes of Blood CellCount and D-dimer concentration in lung cancer patients with thrombosis.Methods ①554 cases of patients with lung cancer were includedbetween January 2012 and November 2013,75 patients with other diseases which lead to high coagulation state were excluded,blood cell count and D-dimer concentration were compared between 64 lung cancer patients were the cases with thrombosis with 415 lung cancer patients were the control group without thrombosis.②Color doppler ultrasonography was taken as the golden standard,receiver operating characteristic curves(ROC)were drawn for indexes which had significance in method.Results ①Compared with lung cancer patients without thrombosis,lung cancer patients without thrombosis had decreased red blood cell count(RBC),increased white blood cell count(WBC)and D-dimer.And there were no significant change in platelet(PLT).②The area under curve(AUC)ofROC in RBC,WBC and D-dimer were 0.662,0.637 and 0.896,respectively.By thecut-off values of RBC>4.06×1012L,WBC<5.37×109/L and D-dimer<4.02 mg/L,the negative predictive values of RBC,WBC and D-dimer for diagnosis of lung cancer patient with thrombosis were 93%,93% and 96%,respectively.By the cut-off value of D-dimer>4.02 mg/L,the positive predictive value of D-dimer for diagnosis of lung cancer patient with thrombosis was 66%.Conclusion RBC,WBC and D-dimer were related with the progress of thrombosis in lung cancer patients.RBC,WBC and D-dimer have good negative prediction effect on lung cancer patients with thrombosis.D-dimer had positive effectfor diagnosis of lung cancer with thrombosis.

参考文献/References:

[1] 杨 玲,王 颖,王 赫,等.肺癌与血栓栓塞性疾病[J].中华临床医师杂志(电子版),2013,5(7):4419-4422. Yang L,Wang Y,Wang H,el al.Lung cancer and thromboembolic disease[J].Chin J Clinicians(Electronic Edition),2013,5(7):4419-4422.
[2] Tagalakis V,Levi D,Agulnik JS,et al.High risk of deep vein thrombosisin patients with non-small cell lung cancer:a cohort study of 493 patients[J].J Thorac Oncol,2007,2(8):729-734.
[3] 张晓伟,史立英,高海燕,等.肺癌患者凝血功能改变的临床意义[J].中国实验诊断学,2013,17(9),1720-1721. Zhang XW,Shi LY,Gao HY,et al.The clinical significance of changes in lung function in patients with coagulation[J].Chinese Journal of Laboratory Diagnosis,2013,17(9),1720-1721.
[4] Pabinger I,Ay C.Risk of venous thromboembolism and primary prophylaxisin cancer.Should all patients receive thromboprophylaxis?[J].Hamostaseologie,2012,32(2):132-137.
[5] 罗 莉.D-二聚体检测及临床应用研究进展[J].四川医学,2010,31(10):1562-1563. Luo L.Clinical application research progress and detection of D-Dimer[J].Sichuan Medicine Journal,2010,31(10):1562-1563.
[6] 张怡梅,陈连刚,高冬梅,等.恶性肿瘤合并血栓栓塞性疾病的危险因素分析[J].中国医药导报,2013,10(4):39-40,43. Zhang YM,Chen LG,Gao DM,et al.Risk factors analysis of malignanttumor combined with tromboembolic disease[J].China Medical Herald,2013,10(4):39-40,43.
[7] 林海英,关 莹.恶性肿瘤血液学改变机制[J].医学综述,2008,14(1):72-74. Lin HY,Guan Y.Mechanism of hematological changes in malignancies[J].Medical Review,2008,14(1):72-74.
[8] Simanek R,Vormittag R,Ay C,et al.High platelet count associated withvenous thromboembolism in cancer patients:results from the Vienna Cancer and Thrombosis Study(CATS)[J].J Thromb Haemost,2010,8(1):114-120.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助(81301493)。
作者简介:刁 雪(1988-),女,医学学士,检验技师,主要从事血栓止血相关疾病研究。
通讯作者:粟 军,女,副教授,E-mail:sjhuaxi 1667@163.com。
更新日期/Last Update: 2015-01-30