摘要
目的探讨中性粒细胞/淋巴细胞比值(NLR)与凝血参数诊断恶性肿瘤患者血液高凝状态的临床价值。方法选取2014年12月至2016年12月该院收治的683例恶性肿瘤患者和200例良性肿瘤患者分别作为恶性肿瘤组和良性肿瘤组,其中恶性肿瘤组按是否合并血液高凝状态进一步分为高凝亚组和非高凝亚组,同时选取143例健康体检者作为对照组,观察各组中性粒细胞计数(NC)、淋巴细胞计数(LY)、NLR、D-二聚体(D-D)、纤维蛋白原(Fib)、血小板计数(PLT)、血小板分布宽度(PDW)水平变化,以及NLR与凝血参数诊断恶性肿瘤的灵敏度和特异度。结果恶性肿瘤组NC、NLR水平高于良性肿瘤组和对照组,而LY水平低于良性肿瘤组和对照组,差异均有统计学意义(P<0.05)。恶性肿瘤组D-D、Fib和PDW水平高于良性肿瘤组和对照组,而PLT水平低于良性肿瘤组和对照组,差异均有统计学意义(P<0.05)。高凝亚组NC、NLR水平高于非高凝亚组,而LY水平低于非高凝亚组,差异均有统计学意义(P<0.05);高凝亚组D-D、Fib和PDW水平高于非高凝亚组,而PLT水平低于非高凝亚组,差异均有统计学意义(P<0.05)。NLR联合凝血参数诊断恶性肿瘤的灵敏度和特异度高于各项单独检测,差异有统计学意义(P<0.05)。结论恶性肿瘤患者血液高凝状态下,NLR水平升高,凝血参数存在明显异常,且NLR与凝血参数联合诊断恶性肿瘤的灵敏度和特异度较高。
Objective To investigate the clinical value of neutrophil lymphocyte ratio(NLR)and coagulation parameters for diagnosing hypercoagulable state in the patients with malignant tumor.Methods A total of683cases of malignant tumor and200cases of benign tumor in this hospital from December2014to December2016were selected as the malignant tumor group and benign tumor group respectively.The malignant tumor group was further divided into the hypercoagulability group and non hypercoagulable group according to the combination of hypercoagulability.Meanwhile143individuals undergoing healthy physical examination were selected as the control group.The changes of neutrophil count(NC),lymphocyte count(LC),NLR,D-dinner,fibrinogen(Fib),platelet count(PLT)and platelet distribution width(PDW)were observed.The sensitivity and specificity of NLR and coagulation parameters for diagnosing hypercoagulable state were analyzed.Results The NC level and NLR in the malignant tumor group were higher than those in the benign tumor group and control group,while the LC level was lower than that in the benign tumor group and control group,the difference was statistically significant(P<0.05).The D-D,Fib and PDW levels in the malignant tumor group were higher than those in the benign tumor group and control group,while the PLT level was lower than that in the benign tumor group and control group,the difference was statistically significant(P<0.05).The NC and NLR levels in the hypercoagulability group were higher than those in the non hypercoagulable group,while the LC level was lower than that in the non hypercoagulable group,the difference was statistically significant(P<0.05);the D-D,Fib and PDW levels in the hypercoagulability group were higher than those in the non hypercoagulable group,while the PLT level was lower than that in the non hypercoagulable group,the difference was statistically significant(P<0.05).The sensitivity and specificity of NLR combined with coagulation parameters for diagnosing malignant tumor were higher than those of single indicator detection.Conclusion In hypercoagulable state patients with malignant tumor,the NLR level increase and the coagulation parameters are obviously abnormal.Therefore NLR combined coagulation parameters has higher the sensitivity and higher specificity for diagnosing malignant tumor.
作者
祝艺华
刘华
ZHU Yihua;LIU Hua(Department of Clinical Laboratory,Yichang Municipal Second People′s Hospital,Yichang,Hubei 443000,China)
出处
《国际检验医学杂志》
CAS
2018年第6期661-663,667,共4页
International Journal of Laboratory Medicine
基金
湖北省自然科学基金项目(2015CFB575)
关键词
中性粒细胞/淋巴细胞比值
凝血参数
恶性肿瘤
高凝状态
neutrophil lymphocyte ratio
coagulation parameters
malignant tumor
hypercoagulable state
作者简介
祝艺华,女,主管技师,主要从事血液细胞形态、临检、生化等研究。
