吉西他滨或多西他赛联合顺铂化疗治疗NSCLC对患者凝血功能CYFRA21-1 CA199的影响  

Effect of Brucea Javanica Oil Emulsion Injection Combined with NP Chemotherapy on Immune Function Coagulation and Pulmonary Function in Patients with Lung Cancer

作　　者：陈丽君[1] 覃世运[1] 刘旭初 陈钟勇 CHEN Lijun;TAN Shiyun;LIU Xuchu(Sanya Central Hospital/the Third People's Hospital of Hainan Province,Hainan Sanya 572000,China)

机构地区：[1]海南省三亚市中心医院/海南省第三人民医院肿瘤治疗中心,海南三亚572000

出　　处：《河北医学》2021年第9期1566-1571,共6页Hebei Medicine

基　　金：海南省卫生健康行业科研项目,(编号:20A200102)。

摘　　要：目的:探究吉西他滨或多西他赛联合顺铂化疗治疗非小细胞肺癌(NSCLC)对患者凝血功能、细胞角蛋白19的可溶性片段(CYFRA21-1)、糖类抗原199(CA199)的影响。方法:回顾性分析2019年1月至2020年1月在本院肿瘤科进行化疗的104例晚期NSCLC患者的病例资料,根据化疗方案将NSCLC分为两组,GP组(吉西他滨联合顺铂)54例,DP组(多西他赛联合顺铂)50例。比较两组化疗效果,化疗前后凝血功能[凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、血小板(PLT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、血浆D-二聚体(D-D)],CYFRA21-1、CA199水平以及毒副反应。结果:GP组和DP组肿瘤控制率分别为83.33%和78.00%,比较差异无统计学意义(P>0.05)。重复测量方差分析显示,FIB在治疗前后的差别有统计学意义(P<0.05),但组间差别无统计学意义(P>0.05);时间与治疗方法的交互作用对TT、PLT的影响有统计学意义(P<0.05),GP组TT、PLT治疗前后差值大于DP组。重复测量方差分析显示,CYFRA21-1、CA199在治疗前后有差别(P<0.05),但在不同治疗方法之间无差别,且治疗方法与时间之间的交互作用无统计学意义(P>0.05)。GP组Ⅰ~Ⅳ级肝功能异常、血小板减少的发生率高于DP组,Ⅰ~Ⅳ级白细胞减少、肌肉酸痛的发生率低于对照组,差异有统计学意义(P<0.05);GP组Ⅲ~Ⅳ级血小板减少的发生率高于DP组,Ⅰ~Ⅳ级白细胞减少的发生率低于对照组,差异有统计学意义(P<0.05)。并且毒副反应大多为Ⅰ~Ⅱ度,基本可自行缓解,而Ⅲ~Ⅳ级经对症处理后明显缓解。结论:GP与DP化疗方案治疗NSCLC疗效相当,对CYFRA21-1、CA199水平的影响差异不大,但GP化疗方案改善血液高凝状态的效果较DP化疗方案显著,且GP化疗方案毒副反应以血小板减少为主,DP化疗方案以白细胞减少为主。Objective:To explore the effects of gemcitabine or docetaxel combined with cisplatin chemotherapy in the treatment of non-small cell lung cancer(NSCLC)on the blood coagulation function,soluble fragments of cytokeratin 19(CYFRA21-1),and carbohydrate antigen 199(CA199).Methods:We retrospectively analyzed the case data of 104 patients with advanced NSCLC who underwent radiotherapy in the oncology department of our hospital from January 2019 to January 2020.According to the chemotherapy regimen,NSCLC was divided into 2 groups,GP group(gemcitabine combined with cisplatin)of 54 cases,and DP group(docetaxel combined with cisplatin)of 50 cases.Comparison of the effects of chemotherapy was conducted between the two groups concerning the coagulation function before and after chemotherapy[thrombin time(TT),activated partial thromboplastin time(APTT),platelets(PLT),prothrombin time(PT),fibrinogen(FIB),plasma D-Dimer(DD)],CYFRA21-1,CA199 levels,and toxic side effects.Results:The tumor control rates of GP group and DP group were 83.33%and 78.00%,respectively,and the difference was not statistically significant(P>0.05).Repeated measures analysis of variance showed that the difference between FIB before and after treatment was statistically significant(P<0.05),but the difference between groups was not statistically significant(P>0.05);the interaction between time and treatment has an effect on TT and PLT Statistically significant(P<0.05),the difference between TT and PLT before and after treatment in the GP group was greater than that in the DP group.Repeated measures analysis of variance showed that CYFRA21-1 and CA199 were different before and after treatment(P<0.05),but there was no difference between different treatment methods,and the interaction between treatment methods and time was not statistically significant(P>0.05).The incidence of abnormal liver function and thrombocytopenia in the GP group was higher than that in the DP group,and the incidence of leukopenia and muscle soreness in the GP group was lower than that in

关 键 词：非小细胞肺癌 吉西他滨 多西他赛 顺铂 

分 类 号：R734.2[医药卫生—肿瘤]