不同方案治疗晚期NSCLC的疗效及对凝血功能和血清CYFRA21-1、IGF-1、VEGF水平的影响  

Effect of gemcitabine,docetaxel,and vinorelbine combined with cisplatin on coagulation function,levels of serum CYFRA21-1,IGF-1,and VEGF of patients with advanced NSCLC

作　　者：黄小青 马庆辉[1] 刘锦基[1] HUANG Xiaoqing;MA Qinghui;LIU Jinji(Department of Oncology and Hematology,the 2 nd People’s Hospital of Foshan,Foshan 528000,Guangdong,China)

机构地区：[1]佛山市第二人民医院肿瘤血液科,广东佛山528000

出　　处：《贵州医科大学学报》2021年第7期863-868,共6页Journal of Guizhou Medical University

基　　金：佛山市科技创新项目(1920001001377)。

摘　　要：目的探讨吉西他滨、多西他赛及长春瑞宾分别联合顺铂对晚期非小细胞肺癌(NSCLC)患者的凝血功能、血清细胞角蛋白19片段(CYFRA21-l)、胰岛素样生长因子-1(IGF-1)、血管内皮生长因子(VEGF)水平的影响。方法120例NSCLC患者均分为吉西他滨联合顺铂治疗组(联合吉西他滨组)、多西他赛联合顺铂治疗组(联合多西他赛组)、长春瑞宾联合顺铂治疗组(联合长春瑞宾组),均治疗3个疗程(每个疗程3周);比较治疗第1、2及3个疗程后3组患者的治疗效果,比较3组患者治疗前及治疗3个疗程后的凝血功能指标及血清CYFRA21-l、IGF-l、VEGF水平变化,记录治疗期间3组患者的毒副反应。结果随着疗程的增加,3组患者的治疗有效率均升高(P<0.05),联合长春瑞宾组治疗有效率高于同疗程联合吉西他滨组和联合多西他赛组(P<0.05);3组患者治疗前的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、D-二聚体(DD)、纤维蛋白原(FIB)、CYFRA21-l、IGF-l、VEGF水平比较差异无统计学意义(P>0.05),治疗后的APTT、PT、TT、DD、FIB、CYFRA21-l、IGF-l水平均低于同组治疗前,VEGF水平高于同组治疗前(P<0.05),联合长春瑞宾组和联合吉西他滨组治疗后的TT水平低于联合多西他赛组(P<0.05);3组患者治疗期间的血小板下降、白细胞下降、贫血、恶心、腹泻、总发生率比较,差异无统计学意义(F=1.823,P>0.05)。结论吉西他滨、多西他赛及长春瑞宾分别联合顺铂治疗晚期NSCLC的疗效和安全性均佳,其机制可能与3种治疗方案有效改善患者凝血功能,降低血清CYFRA21-l、IGF-l水平及提高VEGF水平有关。Objective To investigate the effect of gemcitabine,docetaxel,and vinorelbine combined with cisplatin on coagulation function,levels of serum cytokeratin 19 fragment(CYFRA21-1),insulin-like growth factor-1(IGF-1)and vascular endothelial growth factor(VEGF)of patients of advanced non-small cell lung cancer(NSCLC).Methods One hundred and twenty patients with NSCLC were evenly divided into gemcitabine combined with cisplatin treatment group(combined gemcitabine group),docetaxel combined with cisplatin treatment group(combined docetaxel group)and vinorelbine combined with cisplatin treatment group(combined vinorelbine group)for 3 courses treatment(each course lasted 3 weeks).The treatment efficacy after 1 st course,2 nd course,and 3 rd course of treatment were compared;levels of coagulation function indicators and serum CYFRA21-1,IGF-1,and VEGF before treatment and after 3 courses of treatment were compared,and the occurrence of toxic and side effects in three groups were recorded during treatment.Results With the increment of treatment courses,the effective rates of treatment in three groups were increased(P<0.05);the effective rate of treatment in the combined vinorelbine group was higher than that in the combined gemcitabine group and combined docetaxel group during the same course of treatment(P<0.05).There were no significant differences in the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),D-dimer(DD),fibrinogen(FIB),CYFRA21-1,IGF-1,and VEGF among three groups before treatment(P>0.05).The APTT,PT,TT,DD,FIB,CYFRA21-1,and IGF-1 after treatment in three groups were lower than those before treatment while the level of VEGF was higher than that before treatment in the same group(P<0.05);and the TT levels of the combined vinorelbine group and the combined gemcitabine group were lower than that of combined docetaxel group after treatment(P<0.05).There were no statistical differences in the occurrence of thrombocytopenia,leukopenia,anemia,nausea,and diarrhea,and the total incidence ra

关 键 词：顺铂 治疗结果 晚期非小细胞型肺癌 吉西他滨 多西他赛 长春瑞宾 凝血功能 细胞角蛋白19片段 胰岛素样生长因子-1 血管内皮生长因子 

分 类 号：R734.2[医药卫生—肿瘤]