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Objective To investigate the clinical value of neutrophil lymphocyte ratio(NLR)and coagula-tion parameters for diagnosing hypercoagulable state in the patients with malignant tumor.Methods A total of 683 cases of malignant tumor and 200 cases of benign tumor in this hospital from December 2014 to Decem-ber 2016 were 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.Meanwhile 143 individuals 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 sen-sitivity 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).
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Objective To investigate the change rule of common coagulation indicators and platelet parameters in the patients with chronic viral hepatitis,liver cirrhosis and liver failure.Methods One hundrend and twenty patients with liver diseases in our hospital from January 2015 to June 2016 were selected and divided into chronic viral hepatitis group (46 cases),liver cirrhosis group (Child-Pugh class A,B,C,44 cases) and liver failure group (30 cases).Contemporaneous 30 persons undergoing healthy physical examination served as the healthy control group.The coagulation indicators (PT,PTA,APTT,TT, Fg,D-D) and platelet parameters (PLT,MPV,PDW, PCT) were detected in all subjects.Results Except TT,Fg and D-D had no statistical difference between the healthy control group and chronic viral hepatitis group (P>0.05),PT,APTT and TT in the chronic viral hepatitis group,liver cirrhosis group (Child-Pugh class A,B,C) and liver failure group were gradually extended,PTA and Fg were decreased and D-D value was increased,the difference in pairwise comparison was statistically significant (P<0.05).The PLT value in the chronic viral hepatitis group,liver cirrhosis group (Child-Pugh class A,B,C) and liver failure group was decreased gradually,while the MPV and PDW values were gradually increased,showing significantlystatistically significant difference (P<0.05),the PCT value in the liver cirrhosis group and liver failure group was lower than that in the chronic viral hepatitis group(P<0.05).Conclusion The regularity change of coagulation indicators and platelet parameters occurs in different periods of chronic liver disease progression,which provides some reference for clinical diagnosis,treatment and prognosis judgment.
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Background: Cardiac surgery with cardiopulmonary bypass is grown rapidly in last years. Theapplication of cardiopulmonary bypass using a heart-lung machine to perform open heart surgeryis known to be associated with numerous pathophysiologic changes including injury of cellularcomponents as erythrocyte, platelets, coagulopathy, and fibrinolysis.Objectives: Our study objective is to study on relation of open heart surgery phases and bloodcoagulation parameters.Materials and Methods: Blood samples from 49 patients (28 females and 21 males, aged 18-63 years) who underwent open heart surgery with cardiopulnonary bypass (CPB) were collectedbefore and at several time points during, after surgery and analyzed for coagulation parametersat Shastin Third Central Hospital.Results: To compare long continued cardiopulmonary bypass (over 1 h) surgery with less 1h groups there prothrombin time was found 18.8±5.9 sec, international normalized ratio (INR)2.09±0.9 sec prolonged (p<0.001) in 7 days after surgery. All coagulation parameters weredecreased significantly (p<0.001) in during extracorporeal circulation and after 1 h declampingthan preoperative level and reached near normal value in 48 h after surgery. Our results havereferred to platelet counts reduction to about 53% in during surgery, 46.8% in 48 h after surgeryof the preoperative level 237.4±57.1 with final return to normal levels 228.9±78.6 within 7 days.Conclusions:1. The cardiopulmonary bypass time and patient age in relation to open heart surgery type therewere significant difference (p <0.01).2. The coagulation parameters have revealed significant changes (p <0.01) in relationcardiopulmonary bypass time.3. All coagulation parameters were decreased significantly (p<0.001) in during extracorporealcirculation and after 1 h decamping than preoperative level and reached near normal value in48 h after surgery.4. There was direct and less correlation between platelet level and CPB time (r=0.37, p<0.001).
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Aim: This study was conducted to assess the predictive value of coagulation abnormalities in determining disease severity and prognosis of acute pancreatitis (AP). Methods: Patients of AP and 25 healthy volunteers were included in this prospective observational study. The final outcomes were disease severity assessed by Computed Tomography Severity Index, Acute Physiological Assessment and Chronic Health Evaluation – II, presence of organ failure and mortality. Prothrombin time (PT), partial thromboplastin time (PTT), thrombin time (TT), fibrinogen, antithrombin-III (AT-III), protein-C, and protein-S levels were assessed on day 0, 3 and 7 of admission. Results: Of the 38 patients included, 13 died. Mean PT and TT were similar between patients and controls on any given day. PTT showed elevation on day 3 and 7 (p=0.001) compared to controls, although fibrinogen and D-dimer were significantly higher in patients on all days. Protein C and AT-III were significantly lower in patients and more so in non survivors ( (p=0.001)) than controls. Multiple logistic regression analysis revealed D-dimer levels >400 - 800 ng/ml and AT- III level of <71% at admission were associated with high mortality (OR 11.2, AUROC 0.70 and OR 16.6, AUROC 0.82 respectively) as well as predicted organ failure. Conclusion: Serum D-dimer and antithrombin-III levels can be used to assess disease severity and predict outcome of patients with acute pancreatitis.