小剂量口服沙利度胺对三阴性乳腺癌患者凝血系统功能的影响  

Triple negative breast cancer patients' coagulatory function treated by small dose thalidomide

作　　者：赵羲和[1] 刘磊[2] 李午生[1] 赵力[1] 李凯[1] 

机构地区：[1]中国医科大学附属盛京医院肿瘤科,辽宁沈阳110022 [2]中国医科大学附属盛京医院外科,辽宁沈阳110022

出　　处：《现代肿瘤医学》2014年第8期1837-1840,共4页Journal of Modern Oncology

基　　金：辽宁省教育厅项目(编号:2009A722)

摘　　要：目的:观察三阴性乳腺癌患者服用小剂量沙利度胺前后凝血指标变化,以探讨小剂量沙利度胺是否能增加栓塞事件风险。方法:选取2008年至2012年于中国医科大学附属盛京医院住院的三阴性乳腺癌患者292例,将患者按治疗过程中是否进行化疗分为化疗组(145例)与非化疗组(147例),均给予沙利度胺100mg每日一次口服。服药前和连续服用沙利度胺3个月、6个月后抽取患者外周静脉血,用4色荧光流式细胞仪检测血小板活化程度,自动分析凝血仪检测患者部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(DD)。比较患者血小板活化程度、内外源性凝血途径功能变化。结果:收治的292例患者,去除退组的55例,服用沙利度胺前后APTT、PT值、血小板活化程度均无显著变化。化疗组服沙利度胺前FIB为(3.4±0.92)g/L,DD值为(242.7±249.7)μg/L;服沙利度胺6个月后FIB为(3.9±2.4)g/L(t=-2.48,P=0.021),DD值为(354.2±236.1)μg/L(t=-2.1,P=0.047)。FIB、DD值较前升高,有显著意义。非化疗组FIB值较前升高,但无显著意义(t=-1.83,P=0.078),服药前DD值为(225.6±156.8)μg/L,之后为(267.3±206.7)μg/L,升高有显著意义(t=-2.69,P=0.012)。结论:小剂量口服沙利度胺不能影响三阴性乳腺癌患者血小板活化,亦不能影响内外源凝血因子,但有可能增加深静脉血栓发生几率。To observe the coagulative functional change of TNBC（triple negative breast cancer）pa-tients who take thalidomide 100mg/ d with or without chemotherapy to find whether small dose thalidomide can induce thombosis incidence. Methods：All 292 patients with triple negative breast cancer were divided into chemotherapy group（145 patients）and non - chemotherapy group（147 patients）. Treat them with thalidomide 100mg/ d po for half a year,with chemotherapy simultaneously for chemotherapy group. Draw venous blood before and after taking thalido-mide for three months,six months respectively,analyze the platelet activating degree with fluorescence flow cytometer as well as APTT,PT,FIB,DD with automatic coagulative analysator. Results：Both groups＇APTT,PT value and plate-let activation didn＇t change obviously. Chemotherapy group had obvious change in FIB,（3. 4 ± 0. 92）g/ L before,（3. 9 ± 2. 4）g/ L（P = 0. 021）after taking thalidomide for six months,DD（242. 7 ± 249. 7）μg/ L before,（354. 2 ± 236. 1）μg/ L（P = 0. 047）six months later,non - chemotherapy group＇s mean FIB was higher than before while it didn＇t show statistical significancy（P = 0. 078）. It＇s DD was higher significantly（P = 0. 012）after taking thalidomide. Conclu-sion：Small dose thalidomide po affect neither endogenous and exogenous coagulative factor nor platelet activation of patients with TNBC. It increases the deep vein thrombotic risk especially taken chemotherapy simutaneously.

关 键 词：沙利度胺 三阴性乳腺癌 凝血功能 血栓栓塞 

分 类 号：R737.9[医药卫生—肿瘤]