低分子肝素作用于NSCLC的临床疗效及对患者凝血功能的影响  

Effect of Low Molecular Weight Heparin on Coagulation Parameters in Patients with NSCLC and Clinical Efficacy Analysis

作　　者：王进富[1] 李拥军[2] 吴刚[1] 解楼雯 

机构地区：[1]江苏省盐城市大丰中医院,224100 [2]南通大学附属肿瘤医院,226361

出　　处：《实用癌症杂志》2017年第4期586-589,共4页The Practical Journal of Cancer

摘　　要：目的探讨低分子肝素作用于非小细胞肺癌(NSCLC)的临床疗效及对患者凝血功能的影响。方法使用前瞻性临床研究的方法,随机选取Ⅲ期和Ⅳ期的NSCLC患者140例,通过随机分组法,分为2组。A组为研究组70例,B组为参照组70例。B组采用一线化疗和常规对症治疗方案,A组在B组方案上,采用低分子肝素(LMWH)抗凝治疗。对A、B组治疗结果进行对比分析。结果 A、B组治疗前KPS分别为(78.25±9.62)和(82.25±7.29),差异无统计学意义(P=0.335)。A组治疗前后KPS评分对比,差异无统计学意义(P=0.061);B组治疗前后KPS评分对比,差异有统计学意义(P=0.008);2组治疗后KPS对比,差异有统计学意义(P=0.002)。2组患者凝血指标和正常相比,都表现出不同程度的异常。A组患者治疗前后的凝血指标对比中,TT、Fib、D-D及PLT差异有统计学意义(P=0.002;P=0.001;P=0.014;P=0.004),APTT、PT差异无统计学意义(P=0.128;P=0.065);B组患者治疗前后的凝血指标对比中,D-D、PLT差异有统计学意义(P=0.034;P=0.004),APTT、PT、TT及Fib差异无意义(P=0.119;P=0.139;P=0.532;P=0.431)。治疗前2组患者凝血指标对比差异无统计学意义(P>0.05);治疗后TT、Fib、D-D、PLT方面差异有统计学意义(P=0.007;P=0.017;P=0.034;P=0.001),而在APPT、PT差异无统计学意义(P=0.838;P=0.250)。治疗2周期后,A组和B组总有效率分别为25.71%和17.14%,差异无统计学意义(P=0.371);A组和B组总控制率分别为91.43%和82.86%,差异无统计学意义(P=0.459)。2组抗癌药物的不良反应发生率差异均无统计学意义(P>0.05)。结论 LMWH在治疗NSCLC患者时可以有效改善患者的异常凝血功能指标,同时有效地改善了化疗对患者生活质量的影响。Objective To investigate the effect of low molecular weight heparin in patients with coagulation function changes and clinical efficacy in non-small cell lung cancer （NSCLC）. Methods A prospective clinical study method were used, 140 cases of stage Ⅲ and IV NSCLC patients were randomly divided into 2 groups,each with 70 cases. Group A was the study group, group B was the control group. Group B received first-line chemotherapy and conventional symptomatic treatment, group A received low molecular weight heparin （LMWH） antieoagulation therapy on the basis of group B, treatment results of the 2 groups were analyzed. Results KPS score of group A and B before treatment were （ 78.25 ± 9.62） and （ 82.25 ± 7.29）, A, B groups of patients before treatment KPS score had no significant difference （ P = 0. 335 ）. Coagulation parameters of the 2 groups and normal patients had shown different degrees of abnormality. The comparison between before and after the coagulation treatment of patients in group A, T-F, Fib, DD and PLT were significant （ P = 0. 002 ; P = 0.001 ; P = 0. 014 ; P = 0. 004 ）, APTT, PT were insignificant （P = 0. 128;P = 0. 065 ） ;the comparison between before and after clotting in patients in group B, DD, PLT were significant （P = 0. 034 ; P = 0. 004 ） , APTT ,PT, TT and Fib four indexes were insignificant （ P = 0.119 ; P = 0.139 ; P = 0.532 ; P = 0.431 ） ; before treatment, coagulation indexes between the 2 groups had no significant difference （ P 〉 0.05 ） ; A, B groups among patients treated after coagulation contrast, TT, Fib, DD, PLT were significant （ P = 0. 007 ;P = 0.017 ; P = 0.034 ; P = 0.001 ）, APPT, PT were insignificant （P = 0. 838 ;P = 0. 250）. After 2 cycles of treatment,A, B groups had no CR cases, A group and B group the total effective rate was 25.71% and 17.14% ,there had no significant difference （P =0. 371 ）. A group and B group,the total rates were 91.43% and 82.86%, respectively, there had no significant difference （P = 0. 459）

关 键 词：非小细胞肺癌 低分子肝素 凝血功能 瘤体客观评价 

分 类 号：R734.2[医药卫生—肿瘤]