恶性肿瘤患者2019-nCoV感染前后围化疗期对凝血功能的影响分析  

Analysis of the effect of peri-chemotherapy period on coagulation function before and after COVID-19 infection in patients with malignant tumors

作　　者：季发和 高金平 朴瑛 JI Fahe;GAO Jinping;PIAO Ying(Department of Oncology,General Hospital of the PLA Northern Theater Command,Shenyang 110016,China)

机构地区：[1]解放军北部战区总医院肿瘤科,沈阳110016

出　　处：《临床肿瘤学杂志》2024年第1期56-61,共6页Chinese Clinical Oncology

摘　　要：目的回顾性分析2019冠状病毒(2019-nCoV)感染前后恶性肿瘤患者化疗前后对凝血指标的影响。方法收集2022年10月至2023年4月2019-nCoV感染前后的恶性肿瘤患者62例,记录2019-nCoV感染前每周期化疗前后、感染康复后每周期化疗前后以及第4周期化疗结束后1个月的血常规、凝血指标变化情况。结果与第1周期化疗前比较,化疗后中性粒细胞与淋巴细胞计数比值(NLR)升高,淋巴细胞(LYM)、血小板(PLT)均下降(P<0.05);与第2周期化疗前比较,化疗后NEU、NLR升高,而LYM和PLT下降(P<0.05)。2019-nCoV感染康复后,第3、4周期化疗前后NEU、LYM、NLR、PLT的差异均无统计学意义(P>0.05)。2019-nCoV感染康复后重启化疗前及第4周期化疗结束后1个月NLR明显升高,而LYM和PLT则仍低于化疗前(P<0.05)。第1周期化疗前和第2周期化疗后比较,D-二聚体水平升高(P<0.05)。感染2019-nCoV康复后,第3周期化疗前和第4周期化疗后凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、血浆纤维蛋白原(FIB)、国际标准化比值(INR)和D-二聚体的差异无统计学意义(P>0.05)。感染2019-nCoV康复后重启化疗前及第4周期化疗结束后1个月PT、INR、APTT、FIB和D-二聚体的差异均无统计学意义(P>0.05)。结论处于高凝状态的恶性肿瘤患者合并感染2019-nCoV康复后,化疗不会对凝血功能造成显著影响,在有效控制肿瘤恶性发展的同时不会造成血栓形成风险进一步增加。Objective To retrospectively analyze the impact of chemotherapy before and after the infection with 2019-nCoV on coagulation indicators in patients with malignant tumors.Methods From October 2022 to April 2023,62 patients bearing malignant tumors treated before and after 2019-nCoV infection were enrolled in this study.The changes in blood routine and coagulation indicators before and after each cycle of chemotherapy before 2019-nCoV infection,before and after each cycle of chemotherapy after infection recovery,and one month after the end of the fourth cycle of chemotherapy were recorded.Results Compared with before the first cycle of chemotherapy,the ratio of neutrophil(NEU)to lymphocyte count(NLR)increased after chemotherapy,while lymphocytes(LYM)and platelets(PLT)decreased(P<0.05);Compared with before the second cycle of chemotherapy,NEU and NLR increased,while LYM and PLT decreased after chemotherapy(P<0.05).After rehabilitation from 2019-nCoV infection,there was no statistically significant difference in NEU,LYM,NLR,and PLT before the third cycle and after the fourth cycle of chemotherapy(P>0.05).After the rehabilitation of 2019-nCoV infection,NLR increased significantly before chemotherapy and one month after the fourth cycle of chemotherapy,while LYM and PLT were still lower than those before chemotherapy(P<0.05).Compared with before and after the first cycle of chemotherapy,the level of D-dimer increased(P<0.05).After recorery from 2019-nCoV infection,there was no statistically significant difference in prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),international normalized ratio(INR)and D-dimer between before and after the the third cycle and after the fourth cycle of chemotherapy(P>0.05).There was no statistically significant difference in PT,APTT,FIB,INR and D-dimer before chemotherapy after rehabilitation and one month after the fourth cycle of chemotherapy(P>0.05).Conclusion After 2019-nCoV rehabilitation,chemotherapy does not have significant impact on coagulation fu

关 键 词：恶性肿瘤 2019冠状病毒 化学治疗 凝血功能 

分 类 号：R730.5[医药卫生—肿瘤]