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目的：探讨肾癌患者异常增高的凝血指标、静脉血栓栓塞症(VTE)发生率与临床分期的关系，分析肾癌患者血液高凝状态的临床特征。方法：对 2010 年至 2012 年 335 例住院的肾癌患者 Fib、 D-D、 BPC 水平进行检测并筛查发生 VTE 的患者。结果： 335 例肾癌患者中，异常 Fib、D-D、BPC 的发生率分别为 20.6%、 9.9%、6.6%，且随着肾癌分期的增加，凝血指标异常的发生率逐渐升高，各分期之间比较有统计学差异 (P<0.05)； VTE 的发生率为 2.2%， Ⅳ 期肾癌患者最高为 1 .2%，且各分期之间比较有统计学意义 (P<0.05)。年龄≥ 60 岁、肿瘤最大径 >10 cm、临床分期晚、伴有远处转移的肾癌患者血液高凝的发生率分别显著高于年龄 <60 岁、肿瘤最大径 <1 0 cm、临床分期早、不伴有远处转移的肾癌患者(P<0.05)。结论：年龄≥ 60 岁、肿瘤最大径 >1 0 cm、临床分期晚、伴有远处转移可能是肾癌患者发生血液高凝状态和 VTE 的危险因素，应引起临床重视。

英文摘要:

Objective:To investigate the relationship between abnormal coagulation indexes, incidence rate of venous thromboembolism (VTE) and clinical stages of RCC patients and analyze the clinical features of RCC patients in hypercoagulable state.Methods:The coagulation index (Fib, D-D, BPC) of 355 RCC patients admitted from January 2010 to March 2012 in our hospital were deteced and the incidence of VTE was analyzed.Results:In 355 RCC patients, Fib, D-D, and BPC were abnormally high, the incidence rates of abnormally high Fib, D-D, and BPC levels were respectively 20.6%, 9.9%, and 6.6%. With the increase of stage, the incidence rate of abnormal coagulation indexes also significantly increased (P<0.05). The incidence of VTE was 2.2%, which was 1.2% of patients at Stage Ⅳ , and there was statistical difference between different stages (P<0.05). The incidence rates of hypercoagulability in RCC patients with age ≥ 60 years, tumor size> 10 cm, advanced stage, distant metastasis metastases were significantly higher than those RCC patients with aged <60 years, tumor size <1 0 cm, early stage and without distant metastasis(P<0.05).Conclusion:Age ≥ 60 years, tumor size> 1 0 cm, advanced stage, and distant metastasis may be the risk factors which lead to hypercoagulability and VTE in RCC patients and should be paid attention to.

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