摘要
目的:探讨气虚血瘀证支气管肺癌患者"瘀毒"病机的临床和实验室特点。方法:通过回顾性研究以肺癌气虚血瘀证患者为研究对象,血凝指标、D-二聚体水平为观测指标,观察了气虚血瘀证肺癌患者"瘀毒"病机的临床和实验室特点。结果:入选60例患者中,男性34例,女性26例;病理类型以腺癌、鳞癌为主;临床分期以Ⅲ、Ⅳ多见。与对照组相比,肺癌患者PT显著延长(P<0.05),FIB、D-二聚体水平显著升高(P<0.05);腺癌患者FIB、D-二聚体水平明显高于鳞癌患者(P<0.05);Ⅲ+Ⅳ期患者各凝血指标(TT、APTT、FIB)及D-二聚体显著高于Ⅰ+Ⅱ期(P<0.05);发生转移者PT、FIB、D-二聚体水平显著高于未转移者(P<0.05);吸烟的肺癌患者PT、FIB、D-二聚体水平虽高于不吸烟者,但差异并无统计学意义。结论:支气管肺癌辨证为气虚血瘀证者以中晚期为多,多伴有凝血功能障碍;而凝血指标的改变与肿瘤分期、病理类型、转移情况有一定的关联性,可作为判断肺癌预后的重要因素,其中,D-二聚体、FIB在一定程度上反映了气虚血瘀证肺癌患者存在高凝状态,并可有望成为非常实用的临床诊断气虚血瘀证的微观指标。
Objective:To investigate the clinical and laboratory characteristics of lung cancer patients with toxin-stasis pathogenesis.Methods:Lung cancer with qi deficiency and blood stasis syndrome were involved in this retrospective study.We primarily analyzed the relationship between coagulation index and pathological type,tumor stage and the smoking status,which aimed to provide useful data for the management of lung cancer.Results:In total,there were 34 male and 26 female cases in the study.The main pathological types were adenocarcinoma and squamous carcinoma,and most of the patients belong to the tumor stages ofⅢ,Ⅳ.Compared with the control group,prothrombin time(PT)was significantly prolonged(P<0.05),and the levels of FIB and D-dimer were increased in the patients with lung cancer(P<0.05).Meanwhile,the mean D-dimer and FIB were also significantly higher than that in patients with squamous carcinoma(P<0.05).Compared with the patients ofⅠ,Ⅱstages,in addition to the PT,the remaining coagulation indexes were significantly higher in patients belongs toⅢ,Ⅳstages(P<0.05).Moreover,patients with cancer transferring had significantly higher levels of PT,FIB,D-dimer than that without transfers(P<0.05).However,in the comparison between smokers and non-smokers,there were no differences between the levels of PT,FIB,D-dimer.Conclusion:Qi deficiency and blood stasis syndrome pathogenesis are most commonly seen in lung cancer,and it may always accompany with a coagulation disorder.The coagulopathy is highly related to the tumor stages,pathological type and cancer metastasis,which could be used as an important factor for indicating the prognosis of lung cancer.Therefore,the levels of FIB,D-dimer could serve as important indexes of the blood hypercoagulability in lung cancer that is with of qi deficiency and bloodstasis syndrome.
作者
李晓娟
陈滨海
杨雪静
申力
张光霁
LI Xiao-juan;CHEN Bin-hai;YANG Xue-jing;SHEN Li;ZHANG Guang-ji(The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310006,China;The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,China;China Academy of Chinese Medical Sciences,Beijing 100700,China;Zhejiang Chinese Medical University,Hangzhou 310053,China)
出处
《中华中医药杂志》
CAS
CSCD
北大核心
2019年第2期773-777,共5页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
国家自然科学基金项目(No.81503328
No.81403199)
浙江省自然科学基金项目(No.LQ15H290003)
浙江省中医药优秀青年人才基金项目(No.2017ZQ011)~~
关键词
支气管肺癌
气虚血瘀证
瘀毒病机
临床探讨
D-二聚体
凝血指标
纤维蛋白原
Lung cancer
Qi deficiency and blood stasis syndrome
Toxin-stasis pathogenesis
Clinical research
D-dimer
Coagulation index
Fibrinogen
