肺癌化疗患者合并静脉血栓栓塞症的危险因素及治疗分析  

Risk factors and treatment efficiency for lung cancer patients with venous thromboembolism

作　　者：陈泉芳[1] 王威[2] 邹小英[1] 凌志安[2] 巫艳彬[1] 孔晋亮[1] 徐邦浩[3] 杜清华[4] 

机构地区：[1]广西医科大学第一附属医院呼吸内科,南宁市530021 [2]广西医科大学第一附属医院急诊科,南宁市530021 [3]广西医科大学第一附属医院肝胆外科,南宁市530021 [4]广西医科大学第一附属医院化疗科,南宁市530021

出　　处：《实用医学杂志》2014年第6期891-894,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金(编号:81060002);广西自然科学基金(编号:2013GXNSFBAO19163;2012GXNSFAA276011);广西医科大学青年基金(编号:GXMUYSF201216)

摘　　要：目的:探讨肺癌化疗患者合并静脉血栓栓塞症的危险因素与治疗。方法:282例肺癌化疗患者按有无合并静脉血栓栓塞症(VTE)分成VTE组(n=72)与无VTE组(n=210),记录分析两组的性别、年龄、既往史、病理类型、肿瘤分期、血小板计数、血黏稠度、D-二聚体以及治疗措施。结果:VTE组的腺癌占65.28%、Ⅳ期占87.50%、血黏稠度增高占65.28%和D-二聚体增高占70.83%,均高于无VTE组的51.43%、75.71%、51.43%和56.67%(均P<0.05)。Logistic回归显示:肿瘤分期、D-二聚体水平、吸烟、年龄以及血黏稠度水平与肺癌化疗患者发生静脉血栓高度相关,其OR值分别为3.802、2.339、5.814、3.875与6.404,差异均具有统计学意义(均P<0.05)。治疗效果:72例肺癌化疗合并VTE患者1例并发大出血死亡;其余经积极溶栓、抗凝治疗后36例治愈,8例好转,总有效率为61.11%。结论:Ⅳ期的肺腺癌、吸烟、高龄以及血黏稠度和D-二聚体的增高为肺癌化疗患者合并VTE的重要危险因素;及时评估肺癌化疗患者合并VTE的危险因素与早期抗凝治疗,可提高其疗效并减少并发症的发生。Objective To investigate the risk factors and treatment efficiency for lung cancer patients with venous thromboembolism （VTE）. Methods Total 282 cases of lung cancer patients with VTE were enrolled into two groups, including the VTE group and the non-VTE group, for comparation analysis based on a series of clinical data. Results The occupation rate of adenocarcinoma and 1V period were 65.28% and 87.50% in VTE group, respectively, higher than those of 51.43% and 75.71% in the non-VTE group. The increased rate of blood viscosity and d-dimer respectively were 65.28% and 70.83%, higher than those of 51.43% and 56.67% in the non-VTE group, with significant differences （P 〈 0.05, respectively）. Result of logistic regression analysis showed that tumor stage, d-dimer levels, smoking, age, and blood viscosity levels were highly correlated with venous thrombosis in patients with lung cancer, and the OR value among them was 3.802, 2.339, 5.814, 3.875 and 6.404, respectively, with significant differeneees （P 〈 0.05, respectively）. Conclusions Lung adenocarcinoma with stage 1V, smoking, age and increase of blood viscosity and d-dimer were the important risk factors for VTE in patients with lung cancer chemotherapy. Timely assessment of risk factors and early anticoagulation therapy in lung cancer patients with venous thromboembolism associated with VTE can improve the treatment efficacy and reduce the complications.

关 键 词：肺肿瘤 静脉血栓栓塞症 危险因素 化疗 

分 类 号：R734.2[医药卫生—肿瘤]