【摘要】：目的腫瘤患者體內(nèi)凝血系統(tǒng)異常活化,而糖尿病患者體內(nèi)也存在多種促凝和抗凝成分的改變。本研究探討結(jié)直腸癌(colorectal cancer,CRC)合并2型糖尿病(type 2diabetes mellitus,T2DM)以及單純CRC患者血漿纖維蛋白原(fibrinogen,FIB)和D-二聚體(D-dimer)的變化,及FIB、D-dimer與CRC合并T2DM患者臨床病理特征之間的關(guān)系。方法選取2011-03-07-2015-09-25天津市人民醫(yī)院住院患者1 141例。分為合并組274例和CRC組867例,合并組為CRC合并T2DM患者,CRC組為單純CRC患者。檢測空腹血糖(Glu)、FIB和D-dimer,比較兩組差異。應用單因素方差分析和t檢驗比較患者不同臨床病理特征FIB水平的差異,應用非參數(shù)檢驗比較患者不同臨床病理特征D-dimer水平的差異。結(jié)果合并組FIB水平為(4.16±1.066)g/L,高于CRC組的(3.96±0.935)g/L,t=-2.727,P=0.007;合并組D-dimer水平為0.38(0.26,0.67)mg/L,CRC組D-dimer水平為0.40(0.26,0.66)mg/L,兩者比較差異無統(tǒng)計學意義,Z=0.168,P=0.867。合并組腫瘤長徑≥5cm者FIB(4.41±1.03)g/L高于腫瘤長徑5cm者(3.87±1.01)g/L,t=-3.946,P0.001;pT_(3-4)期腫瘤患者FIB(4.21±1.04)g/L高于pT_1~T_2期的(3.78±1.01)g/L,t=-2.295,P=0.023;低、中分化患者FIB水平(4.70±1.00、4.20±1.03)g/L高于高分化患者(3.83±1.10)g/L,F=4.262,P=0.015。合并組女性D-dimer水平0.51(0.32,1.08)mg/L高于男性0.34(0.26,0.55)mg/L,Z=3.797,P0.001;結(jié)腸癌患者D-dimer水平0.47(0.31,0.78)mg/L高于直腸癌患者0.34(0.26,0.61)mg/L,Z=2.492,P=0.013;pT_3~T_4期患者D-dimer水平0.39(0.26,0.72)mg/L高于pT_1~T_2期者0.32(0.24,0.42)mg/L,Z=2.090,P=0.037。結(jié)論 CRC合并T2DM患者血液處于高凝狀態(tài)。CRC合并T2DM患者術(shù)前高FIB和D-dimer水平與較大的腫瘤直徑和較差的腫瘤病理分期、分化有關(guān)。
[Abstract]:Objective to study the abnormal activation of coagulation system in tumor patients and the changes of anticoagulant and procoagulant components in diabetic patients. This study was to investigate the changes of plasma fibrinogen (fibrinogen,FIB) and D-dimer (D-dimer) and FIB, in patients with colorectal cancer (colorectal cancer,CRC) complicated with type 2 diabetes mellitus (type 2diabetes mellitus,T2DM) and simple CRC. The relationship between D-dimer and the clinicopathological features of CRC patients with T2DM. Methods 1 141 inpatients in Tianjin people's Hospital were selected from 2011-03-07-2015-09-25. The patients were divided into the combined group (274 cases) and the CRC group (867 cases). The combined group was CRC with T2DM and the CRC group was simple CRC. Fasting blood glucose (Glu), FIB) and D-dimer (D-dimer) were measured and compared between the two groups. Univariate ANOVA and t-test were used to compare the differences of FIB levels in different clinicopathological features and non-parametric tests were used to compare the differences of D-dimer levels in different clinicopathological features of the patients. Results the FIB level in the combined group was (4.16 鹵1.066) g / L, higher than that in the CRC group (3.96 鹵0.935) g / L) -2.727 g / L, respectively. The D-dimer level in the combined group was 0.38 (0.260.67). The D-dimer level in the mg/L,CRC group was 0.40 (0.260.66) mg/L, but there was no significant difference between the two groups. FIB (4.41 鹵1.03) g / L in patients with long diameter 鈮，

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