| 许婵,潘连连,蒋雷,袁武锋,费鲜明.中性粒-淋巴细胞比值与凝血参数对恶性肿瘤患者高凝状态的诊断价值比较[J].浙江中西医结合杂志,2017,27(2): |
| 中性粒-淋巴细胞比值与凝血参数对恶性肿瘤患者高凝状态的诊断价值比较 |
| Compare neutrophil-to-lymphocyte ratio and coagulation parameters for diagnostic value of hypercoagulability of malignant tumors |
| 投稿时间：2016-04-14 修订日期：2016-12-02 |
| DOI： |
| 中文关键词: 恶性肿瘤 中性粒-淋巴细胞比值 凝血参数 高凝状态 诊断 |
| 英文关键词:Malignant Neutrophil-to-lymphocyte ratio Coagulation parameters Hypercoagulability diagnosis |
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| 中文摘要: |
| 目的 观察中性粒-淋巴细胞比值(NLR)及凝血参数在恶性肿瘤患者中的变化,探讨其对恶性肿瘤患者血凝状态的诊断价值。方法 测定143例恶性肿瘤、55例良性疾病和50健康人员(对照组)患者白细胞(WBC)和血小板(PLT)参数、C反应蛋白(CRP)、纤维蛋白原(FIB)、D-二聚体(D-D)水平和抗凝血酶(AT) 、凝血因子V、VIII(FV、FVIII)活性,计算NLR和血小板-淋巴细胞比值(PLR),分析各指标与FV和FVIII活性的相关性,并采用ROC曲线评价各指标对高凝状态的诊断价值。结果 恶性肿瘤组NLR、PLR、CRP、FIB、D-D和FV、FVIII水平均显著高于而AT水平显著低于良性疾病组和正常对照组(P<0.001),三组间WBC、PLT差异无统计学意义(P〉0.05)。恶性肿瘤组FV和FVIII活性与NLR、PLR、CRP、FIB和D-D水平均呈显著正相关,与AT活性呈显著负相关(P均<0.01)。NLR的特异性、Youden指数和正确度最高,NLR的ROC曲线下面积最大,为0.923,95%CI(0.880~0.966),其对血液高凝状态的诊断界值为2.20,其敏感度为84.62%,特异性为71.4%,Youden指数位0.56,正确度为86.7%。结论NLR在恶性肿瘤患者高凝状态诊断中具有重要价值。 |
| 英文摘要: |
| objective: To study the changes of neutrophil-to-lymphocyte ratio (NLR) and coagulation parameters in the malignant tumor patients, investigate on the value of diagnosing hypercoagulability of malignant tumors.
Methods: By determining leukocyte (WBC), Blood platelet(PLT),C-reactiveprotein(CRP)Fibrinogen(FIB),D-dimer(D-D),Antithrombin(AT)、Coagulation factors V, VIII(FV、FVIII)activity from 143 cases of malignant tumor,55 cases of benign disease and 50 healthy people(normal control group),calculating NLR and PLR,analyzing the correlation of FV and FVIII activity and other parameters,and using ROC curve,to evaluate the diagnostic value of each parameter on hypercoagulability.
Results: Compare NLR, PLR, CRP, FIB, D-D and FV, FVIII levels of Malignant group were significantly higher than benign group and normal control group,and the AT was significantly lower than benign disease group and normal control group (P <0.001). No significant difference among the three groups with WBC and PLT(p>0.05). The FV and FVIII activity of Malignant group were significantly positively correlated with NLR, PLR, CRP, FIB and D-D levels,and was significantly negatively correlated with the AT(p<0.01). The NLR had the top of the specificity, accuracy and Youden index.The area under the ROC curve of maximum,is 0.923，95%CI（0.880~0.966）. The diagnostic value of blood hypercoagulability, the sensitivity, specificity, Youden index and accuracy were 2.20,84.62%,71.4%, 0.56,86.7%.
Conclusion:The NLR has important value in the diagnosis of malignant tumors with hypercoagulability. |
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