贵州医科大学学报

2017, v.42;No.206(11) 1297-1301

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原发性肝癌患者治疗后血清AFP、NLR、PLT及部分凝血指标的变化
The Changes of AFP,NLR,PLT and Partial Coagulation Index in Primary Hepatocellular Carcinoma

魏容;梁艳丽;王明霞;李红燕;杨娜;
WEI Rong;LIANG Yanli;WANG Mingxia;LI Hongyan;YANG Na;Department of Clinical Laboratory,Suining Central Hospital;

摘要(Abstract):

目的:探讨原发性肝癌(HCC)治疗前后甲胎蛋白(AFP)、中性粒细胞与淋巴细胞的比率(NLR)、血小板(PLT)及部分凝血指标的水平变化。方法:266例HCC患者分别采用手术切除、肝动脉介入化疗或放疗,于治疗前、治疗后第3、10及30天清晨空腹取静脉血分别检测AFP、NLR、PLT、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)、D二聚体(D-D),比较HCC患者治疗前后的水平变化及不同NLR的HCC患者的生存率。结果:HCC患者经治疗后,NLR在第10天、第30天显著下降,PLT在治疗后第3天下降明显;PT、APTT治疗后第3天先升高,治疗后第10天降低,治疗后第30天降至治疗前水平,差异有统计学意义(P<0.05);Fbg先升高后降低,而D-D在治疗后第3天、治疗后第10天显著升高,其后显著下降,AFP随治疗时间呈显著性下降,差异有统计学意义(P<0.05);低NLR组中位生存时间为18个月,而高NLR则为13个月,低NLR患者治疗效果较高NLR患者好(χ2=20.046,P<0.05)。结论:治疗前较高的NLR对治疗的预后较差,降低了HCC患者治疗后的生存率。
Objective: To explore the changes of alpha fetoprotein( AFP),neutrophil to lymphocyte ratio( NLR),platelet( PLT) and partial coagulation index in primary hepatocellular carcinoma( HCC) before and after treatment. Methods: 266 patients with HCC underwent surgical resection,hepatic artery interventional chemotherapy or radiotherapy respectively. The levels of AFP,NLR,PLT,prothrombin time( PT),activated partial thromboplastin time( APTT),d-dimer( D-D) were determine and compared before treatment and on the 3 rd,the 10 th,the 30 thday after treatment. Survival rates of HCC patients with different NLR were compared. Results: NLR of patients with HCC decreased significantly on the 10 thand 30 thday after treatment; PLT decreased significantly on the 3 thday after treatment; PT and APTT rose on the 3 rdday after treatment,dropped on the 10 thday,then returned to the level before treatment on the 30 th( P < 0. 05); Fbg increased first then decreased,and D-D went up obviously on the 3 rdand 10 thday after treatment,afterwards descended; AFP went down apparently over the treatment time. The median survival time in low NLR group and high NLR group after treatment were 18 months and 13 months respectively,the therapeutic effectiveness in low NLR group was better than that in high NLR group. Conclusion: Higher NLR before treatment is associated with poorer prognosis,and reduce the survival rate of HCC patients after treatment.

关键词(KeyWords): 原发性肝癌;纤维蛋白原;D二聚体;甲胎蛋白;凝血指标;中性粒细胞与淋巴细胞比率
primary hepatocellular carcinoma;fibrinogen;d-dimer;alpha-fetoprotein;coagulation index;neutrophil to lymphocyte ratio

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基金项目(Foundation): 国家自然科学基金(31560270)

作者(Author): 魏容;梁艳丽;王明霞;李红燕;杨娜;
WEI Rong;LIANG Yanli;WANG Mingxia;LI Hongyan;YANG Na;Department of Clinical Laboratory,Suining Central Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2017.11.013

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