实用临床医药杂志2025，Vol.29Issue(22)：34-39,6.DOI:10.7619/jcmp.20253524
食管癌凝血紊乱多模态预警模型:基于血栓弹力图与常规凝血指标联合动态监测的预后评估体系
Multimodal warning model for coagulopathy in esophageal cancer:a prognostic dynamic assessment system integrating thromboelastography and conventional coagulation parameters
摘要
Abstract
Objective To explore the value of thromboelastography(TEG)combined with con-ventional coagulation indicators in evaluating the coagulation function of patients with esophageal cancer and its relationship with prognosis.Methods A total of 100 patients with esophageal cancer admitted to our hospital from August 2018 to August 2020 were selected as the study subjects.They were divided into study group(hypercoagulable state)and control group(non-hypercoagulable state)according to the presence or absence of venous thrombosis,and further divided into good prognosis group(survival,n=66)and poor prognosis group(death,n=34)according to their prognosis.TEG indicators[clot formation time(K),reaction time(R),maximum amplitude(MA),coagulation index(CI),and clot formation rate(Angle)]were detected using a TEG instrument;conventional coagu-lation indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB)]were detected using an automatic coagulation analyser;Pearson correlation analysis was used to explore the correlation between TEG indicators and conventional co-agulation indicators;logistic regression analysis was used to explore the influencing factors of coagu-lation function in patients with oesophageal cancer;receiver operating characteristic(ROC)curves were drawn to analyse the value of TEG combined with conventional coagulation indicators in evalua-ting the coagulation function of patients with esophageal cancer.Results The K and R values in the study group were shorter than those in the control group,while the MA,CI,and Angle values were larger,with statistically significant differences(P＜0.05).The PT,APTT,and TT values in the study group were shorter than those in the control group,and the FIB level was higher,with sta-tistically significant differences(P＜0.05).According to Pearson correlation analysis,PT,APTT,and TT were positively correlated with K and R,and negatively correlated with MA,CI,and Angle(P＜0.05);FIB was negatively correlated with K,and R and positively correlated with MA,CI,and Angle(P＜0.05).Multivariate logistic regression analysis showed that larger MA,high CI,larger Angle,and high FIB level were risk factors for the coagulation function of patients with esoph-ageal cancer,while longer PT,APTT,TT,K,and R were protective factors(P＜0.05).The ROC curve showed that the area under the curve(AUC)for the combined evaluation of the coagulation function of patients with oesophageal cancer using K,R,MA,CI,Angle,PT,APTT,TT,and FIB was 0.987,which was superior to the evaluation by each indicator alone(P＜0.05).The K,R,PT,APTT,and TT values in the poor prognosis group were shorter than those in the good prognosis group,while the MA,CI,Angle,and FIB levels were larger or higher,with statistically significant differences(P＜0.05).Conclusion The parameter combination model established by combining TEG with conventional coagulation indicators can improve the evaluation value of the coagulation function and prognosis of patients with oesophageal cancer.关键词
血栓弹力图/凝血指标/食管肿瘤/血液凝固/预后/凝血指数/凝血酶原时间/活化部分凝血酶原时间/纤维蛋白原Key words
thromboelastography/coagulation indicators/esophageal neoplasms/blood co-agulation/prognosis/coagulation index/prothrombin time/activated partial thromboplastin time/fi-brinogen分类
医药卫生引用本文复制引用
KONG Bin,XING Meifang,BAO Shenglan,ZHAO Jun..食管癌凝血紊乱多模态预警模型:基于血栓弹力图与常规凝血指标联合动态监测的预后评估体系[J].实用临床医药杂志,2025,29(22):34-39,6.基金项目
宜兴市重点科技计划项目(21KJJH0007) （21KJJH0007）
