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目的应用Cox比例风险模型探讨原发性肝癌的临床分期和患者生存期与凝血功能的相关性,为临床治疗和预后提供可靠的评价指标。方法对228例原发性肝癌患者、52例普通肝病患者和52例健康对照者进行了血浆凝血功能检测,并观察肝癌分期与凝血功能的关系;进行随访并收集相关的预后资料。采用Cox比例风险模型分析凝血指标和原发性肝癌晚期患者生存期及血栓性疾病的关系。结果原发性肝癌患者凝血指标变化不仅与健康对照组的差异显著,而且随着肝癌分期程度的加重,凝血功能障碍加剧(P<0.05);D-聚体(D-dimer)、纤维蛋白原降解产物(FDP)、纤维蛋白原(FIB)和血小板(PLT)水平与晚期肝癌患者的远期生存呈负相关。结论凝血功能指标的检测能从多方面及时、准确地反映肝癌患者肝脏的损害程度及危险程度,动态地观察凝血功能指标有利于对肝癌患者的病情进行更好的监测和治疗。
Objective To explore the clinical staging of primary hepatocellular carcinoma (HCC) and the relationship between survival and coagulation function using Cox proportional hazards model to provide a reliable evaluation index for clinical treatment and prognosis. Methods 228 cases of primary hepatocellular carcinoma, 52 cases of common liver disease and 52 healthy controls were tested for plasma coagulation function. The relationship between the staging of hepatocellular carcinoma and coagulation function was observed. The follow-up and related prognostic data were collected. The Cox proportional hazards model was used to analyze the relationship between coagulation parameters and survival and thrombotic disease in patients with advanced primary liver cancer. Results The changes of coagulation index in patients with primary liver cancer were not only significantly different from those in healthy controls, but also increased with the progression of liver cancer (P <0.05). D-dimer, fibrinogen The levels of FDP, fibrinogen (FIB) and platelet (PLT) were negatively correlated with the long-term survival of patients with advanced liver cancer. Conclusion The detection of coagulation indexes can timely and accurately reflect the extent and degree of liver damage in patients with liver cancer. Dynamic observation of coagulation indexes is conducive to better monitoring and treatment of liver cancer patients.