标题：乳腺癌患者新辅助化疗前后凝血功能、纤溶功能及血小板参数的变化及临床意义

      作者：郭宏果，刘军，程才，乔松，陆婉玲    郭宏果，刘军，程才，乔松，陆婉玲空军第九八六医院肿瘤血液科，陕西 西安 710054

      卷次： 2023年34卷11期

      【摘要】 目的 探究乳腺癌患者新辅助化疗前后凝血功能、纤溶功能及血小板参数的变化及临床意义。方法 选取 2018年 2月至 2021年 4月空军第九八六医院收治的91例女性乳腺癌患者纳入观察组，予以新辅助化疗，另选取同期于本院体检的63例女性健康人群纳入对照组。比较观察组患者化疗前后、不同疗效患者、观察组和对照组间的凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血小板参数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)以及血小板分布宽度(PDW)。结果 91例患者完成3~5个化疗周期，其中75例实际完成3个周期，16例完成4个及以上的化疗周期，而完全缓解(CR) 25例、部分缓解(PR) 48例、稳定(SD)11例、进展(PD) 7例，总有效率为80.22%；乳腺癌患者新辅助化疗前的FIB及PLT、PCT、MPV[(4.42±0.41) g/L、(286.75±11.23)×109/L、(0.24±0.16)%、(8.82±0.62) fL]明显高于对照组[(3.32±0.45) g/L、(211.43±11.19)×109/L、(0.23±0.12)%、(8.43±0.62) fL)]，差异均有统计学意义(P<0.05)；新辅助化疗后患者的TT、PT、APTT、FIB、PLT、MPV较化疗前显著下降，差异均有统计学意义 (P<0.05)；新辅助化疗后，有效组和无效组患者的 TT、PT、APTT、PLT、PCT、MPV、PDW均明显低于化疗前，且有效组患者的上述各项指标明显低于无效组，差异均有统计学意义(P<0.05)。结论 实时监测凝血、纤溶功能及血小板参数对乳腺癌患者新辅助化疗疗效及预后评估具有较为重要的临床意义。
      【关键词】 乳腺癌；新辅助化疗；凝血功能；纤溶功能；血小板参数；临床意义
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2023）11—1586—04

Changes and clinical significance of coagulation function, fibrinolysis function, and platelet parameters in breastcancer patients before and after neoadjuvant chemotherapy.
GUO Hong-guo, LIU Jun, CHENG Cai, QIAO Song, LUWan-ling. Department of Oncology and Hematology, the 986th Hospital of the Air Force, Xi'an 710054, Shaanxi, CHINA
【Abstract】 Objective To investigate the changes and clinical significance of coagulation function, fibrinolysisfunction, and platelet parameters in breast cancer patients before and after neoadjuvant chemotherapy. Methods A totalof 91 female breast cancer patients who underwent neoadjuvant chemotherapy in the 986th Hospital of Air Force fromFebruary 2018 to April 2021 were selected as the observation group. At the same time, 63 female healthy individualswho underwent physical examinations in the hospital were selected as the control group. Thrombin time (TT), prothrom-bin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), platelet count (PLT), thrombocytocrit(PCT), mean platelet volume (MPV), and platelet distribution width (PDW) in the observation group were compared be-fore and after chemotherapy. These indicators in patients with different curative effects were comparatively analyzed.The indicators were compared between the observation group and the control group. Results All patients enrolled com-pleted 3-5 cycles of chemotherapy. Specifically, 75 patients completed 3 cycles and 16 patients completed 4 or morecycles of chemotherapy. There were 25 patients with complete response (CR), 48 patients with partial response (PR),11 patients with stable disease (SD), and 7 patients with progressive disease (PD), with a total effective rate of 80.22%.FIB, PLT, PCT, and MPV in the observation group before neoadjuvant chemotherapy were (4.42±0.41) g/L, (286.75±11.23)×109/L, (0.24±0.16)%, and (8.82±0.62) fL, significantly higher/larger than (3.32±0.45) g/L, (211.43±11.19)×109/L,(0.23±0.12)%, and (8.43±0.62) fL in the control group (P<0.05). After neoadjuvant chemotherapy, TT, PT, APTT, FIB,PLT, and MPV decreased significantly (P<0.05); the indicators in the effective group were significantly shorter/lower/smaller than those in the ineffective group; the differences were statistically significant (P<0.05). Conclusion Real-timemonitoring of coagulation function, fibrinolysis function, and platelet parameters is of great significance for efficacyevaluation of neoadjuvant chemotherapy and prognosis of breast cancer patients.
      【Key words】 Breast cancer; Neoadjuvant chemotherapy; Coagulation function; Fibrinolysis function; Platelet pa-rameter; Clinical significance