晚期非小细胞肺癌患者化疗前后凝血指标的变化  

Changes in Coagulation Indexes of Patients with Advanced Non-Small Cell Lung Cancer before and after Chemotherapy

作　　者：崔元生[1] 杨莺[1] 阮巧玲[1] 

机构地区：[1]福建医科大学附属宁德市医院胸心外科,福建宁德352100

出　　处：《南昌大学学报（医学版）》2014年第4期34-37,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨晚期非小细胞肺癌(NSCLC)患者化疗前后凝血指标的改变及其临床意义。方法选取48例晚期NSCLC患者(肺癌组,按治疗效果再将完全缓解+部分缓解的患者归为有效组;稳定+进展归为无效组),选取同期健康体检者作为对照组(n=25)。测量对照组及肺癌组化疗前后的血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(D-D)、血小板(PLT)及抗凝血酶Ⅲ(AT-Ⅲ)等指标。结果肺癌组化疗前与对照组比较Fib、D-D、PLT显著升高(P<0.05),AT-Ⅲ显著降低(P<0.05),2组PT及APTT比较差异无统计学意义(P>0.05)。有效组与无效组化疗前各项指标差异无统计学意义(P>0.05);有效组化疗后较化疗前Fib、D-D、PLT显著降低(P<0.05),AT-Ⅲ显著升高(P<0.05),PT及APTT差异无统计学意义(P>0.05);无效组化疗前后各项指标差异无统计学意义(P>0.05)。结论凝血指标的显著变化对晚期NSCLC的诊断有一定价值;晚期NSCLC存在凝血功能异常,有效的化疗可改善患者的凝血功能状态,凝血指标的显著变化可作为患者化疗效果及预后评判的参考依据。Objective To investigate the changes in coagulation indexes before and after chem-otherapy and their clinical significance in patients with advanced non-small cell lung cancer （NSCLC）.Methods Prothrombin time（PT）,activated partial thromboplastin time（APTT）,fi-brinogen（Fib）,D-dimer（D-D）,platelet（PLT）,antithrombin Ⅲ（AT-Ⅲ）and other coagulation in-dexes were measured before and after chemotherapy in 48 patients with advanced NSCLC（NSCLC group）and 25 healthy subjects（control group）.In addition,patients with advanced NSCLC were further divided into two groups：effective group（complete remission＋partial remission）and inef-fective group（stable disease＋progressive disease）.Results Compared with control group,levels of Fib,D-D and PLT increased and levels of AT-Ⅲ decreased in NSCLC group before chemothera-py（P〈0.05）.No significant differences in PT and APTT were found between the two groups be-fore chemotherapy（P〉0.05）.Moreover,there were no significant differences in all indexes be-tween effective group and ineffective group before chemotherapy（P〉0.05）.In effective group, levels of Fib,D-D and PLT decreased and levels of AT-Ⅲ increased after chemotherapy （P〈0.05）,but no obvious changes were found in PT and APTT after chemotherapy（P〉0.05）.In in-effective group,all indexes were not changed after chemotherapy（P〉0.05）.Conclusion Changes＆amp;nbsp;in coagulation indexes are valuable for the diagnosis of advanced NSCLC.Patients with advanced NSCLC have abnormal coagulation function,which can be improved by effective chemotherapy. Therefore,changes in coagulation indexes can be used as the reference for the evaluation of chem-otherapy efficacy and prognosis in patients with advanced NSCLC.

关 键 词：非小细胞肺癌 晚期 化疗 凝血指标 

分 类 号：R734.2[医药卫生—肿瘤]