低分子肝素钠联合化疗在晚期非小细胞肺癌合并高凝状态的有效性及安全性研究  

A study on efficacy and safety of low molecular heparin sodium combined with chemotherapy in treatment of advanced non-small cell lung cancer combined with high coagulation state

作　　者：李磊[1] 钟敏钰[1] 郭培中[1] 邱会[1] 但丹[1] 孔娜[1] 

机构地区：[1]武汉市第一医院(武汉市中西医结合医院)肿瘤科,湖北430022

出　　处：《社区医学杂志》2016年第7期9-12,共4页Journal Of Community Medicine

摘　　要：目的低分子肝素钠联合化疗治疗晚期非小细胞肺癌,观察患者血液高凝状态的变化、静脉血栓症（venous thromboembolism,VTE）的发生率、临床疗效变化及出血风险。方法选取2013年9月—2015年2月间收治的189例晚期非小细胞肺癌患者随机分为对照组（单纯化疗）62例、低剂量组（低分子肝素钠5 000U 1次/d＋化疗）64例和标准剂量组（低分子肝素钠5 000U 12 h/次＋化疗）63例,每组患者化疗周期数为4~6个。观察三组间凝血功能指标的变化、静脉血栓症的发生率、临床疗效及出血概率。计量资料采用方差分析,计数资料采用χ2检验,P〈0.05为差异有统计学意义。结果三组间治疗后APTT、PT均值无显著变化,对比差异均无统计学意义（均P〉0.05）。三组D-二聚体均值分别是（0.95±0.20）、（0.28±0.12）、（0.25±0.15）mg/L,对比差异均有统计学意义（均P〈0.05）。Fig均值分别是（4.68±1.23）、（2.56±0.85）、（2.69±0.78）g/L,对比差异均有统计学意义（均P〈0.05）。三组血栓发生率分别是17.74%、6.25%和4.76%,对比差异均有统计学意义（均P〈0.05）。三组间临床有效率分别是35.5%、40.6%和42.9%,三组间出血概率分别是9.68%、12.5%和14.3%,对比差异均有统计学意义（均P〉0.05）。结论低分子肝素钠联合化疗可以纠正晚期非小细胞肺癌患者的高凝状态,降低VTE的发生概率,有提高临床近期有效率的趋势,出血风险无显著增加,低剂量低分子肝素钠疗效相当。Objective The low molecular heparin sodium combined with chemotherapy were used to treat advanced non- small cell lung cancer,the changes of high blood coagulation state in patients were observed,and the occurrence of venous thromboembolism（VTE）,changes of clinical efficacy and the risk of hemorrhage were evaluated.Methods From September 2013 to February 2015,189 patients with advanced non- small cell lung cancer were divided into following 3 groups：Control Group（chemotherapy only） consisting of 62 patients,Low- dosage Group（lowmolecular heparin sodium 5 000 U 1 times/d＋chemotherapy） consisting of 64 patients and the Standard- dosage Group（low molecular heparin sodium 5 000 U 12 h/times＋chemotherapy） consisting of 63 patients.The patients of every group were treated for 4- 6 cycles.Changes of coagulation function index in above three groups were observed and the occurrence of venous thromboembolism,clinical efficacy and the probability of hemorrhage were evaluated.Measurement data was processed by the F test,count data by χ2test,the result of P〈0.05 was considered statistically significant.Results In all three groups,there were no significant changes of APTT and PT mean values（all P〈0.05）.The mean values of D- dimer were（0.95±0.20）,（0.28±0.12）and（0.25±0.15） mg/L respectively（all P〈0.05）.The mean values of Fig were（4.68±1.23）,（2.56±0.85）and（2.69±0.78）g/L respectively（all P〈0.05）.For the three group s,the occurrence of VTE were 17.74%,6.25% and 4.76%respectively（all P〈0.05）,the clinical efficacy were 35.5%,40.6% and 42.9% respectively（all P〈0.05）,while the probability of hemorrhage were 9.68%,12.5% and 14.3% respectively（all P〈0.05）.Conclusion Low molecular heparin sodium combined with chemotherapy can correct the high coagulation state in patients with advanced non- small cell lung cancer,decrease the probability of VTE and show a tendency to increase short- term clinical efficacy,without significant increase of the risk of

关 键 词：晚期非小细胞肺癌 血液高凝 静脉血栓事件 低分子肝素钠 化疗 

分 类 号：R734.2[医药卫生—肿瘤]