国际肿瘤学杂志

国际肿瘤学杂志 ›› 2015, Vol. 42 ›› Issue (6): 410-413.doi: 10.3760/cma.j.issn.1673-422X.2015.06.003

• 论著 • 上一篇    下一篇

非小细胞肺癌带瘤生存患者预防抗凝治疗疗效分析

吴铁鹰,李改兰,陈琳,韩小龙   

  1. 030001太原，解放军第264中心医院肿瘤中心
  • 收稿日期:2014-12-02 出版日期:2015-06-08 发布日期:2015-05-31
  • 通讯作者: 李改兰，Email：364937115@qq.com E-mail:364937115@qq.com

Effect analysis of prophylactic anticoagulation in the patients with nonsmall cell lung cancer

Wu Tieying, Li Gailan, Chen Lin, Han Xiaolong   

  1. Department of Oncology, Chinese People′s Liberation of Army 264 Hospital, Taiyuan 030001, China
  • Received:2014-12-02 Online:2015-06-08 Published:2015-05-31
  • Contact: Li Gailan E-mail:364937115@qq.com

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摘要： 目的探讨非小细胞肺癌（NSCLC）带瘤生存患者预防抗凝治疗疗效。方法将159例未合并静脉血栓栓塞（VTE）带瘤状态NSCLC患者应用随机数表法分为抗凝治疗组（81例）和对照组（78列）。治疗组81例在常规抗肿瘤治疗同时给予抗凝治疗，低分子肝素钙5 000单位每12小时1次，干预时间为10～30 d。对照组78例仅给予常规抗肿瘤治疗。结果NSCLC患者抗凝治疗后凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）较对照组延长，分别为(15.16±2.12)s∶(13.56±4.30)s；t=3.195，P=0.001、(30.26±3.28)s∶(28.24±5.28)s；t=2.712，P=0.007。纤维蛋白原（FIB）数值较对照组显著降低，分别为(3.85±0.75)g/L∶(4.25±2.65)g/L；t=2.971，P=0.003。抗凝治疗组和对照组患者血栓发生率分别为2.47%、16.67%，差异有统计学意义（χ2=9.901，P=0.002)。治疗组1、2年总生存率均高于对照组，差异均有统计学意义（χ2=5.496，P=0.026；χ2=4.540，P=0.046)；两组1、2年无进展生存率差异均无统计学意义（χ2=2.034，P=0.182；χ2=0.091，P=0.395）。治疗组和对照组患者出血（4.94%∶6.41%）、血小板减少（9.88%∶8.98%）、皮肤坏死（3.70%∶1.28%）发生率差异均无统计学意义（χ2=0.516，P=0.685，χ2=0.008，P=1.000，χ2=0.847，P=0.632）。结论NSCLC患者预防性抗凝治疗可改善凝血状态，减少血栓发生，延长OS，并且无明显不良反应发生。

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Abstract: ObjectiveTo evaluate the effect of anticoagulant therapy in the patients with nonsmall cell lung cancer (NSCLC). MethodsOne hundred and fiftynine patients with NSCLC without venous thromboembolism (VTE) were divided into anticoagulant therapy group (81 cases) and control group (78 cases) by random number table method. The 81 cases in anticoagulant therapy group were treated with antitumor therapy and anticoagulant therapy, using low molecular heparin calcium 5 000 U subcutaneous injected for 1030 days, once every 12 hours. The 78 cases in control group were merely treated with antitumor therapy. ResultsAfter treated with anticoagulation therapy, patients in anticoagulant therapy group had prolonged prothrombin time ［(13.56±4.30)s vs (15.16±2.12)s; t=3.195, P=0.001］, active partial thromboplastin time ［(28.24±5.28)s vs (30.26±3.28)s; t=2.712, P=0.007)］, and a lower FIB ［(3.85±0.75)g/l vs (4.25±2.65)g/l; t=2.971, P=0.003］ compared with the patients in control group. The incidence of thrombosis rates of the two groups were 2.47% and 16.67% respectively, with statistical significance (χ2=9.901, P=0.002). Both the 1, 2 years overall survival rates of patients in anticoagulant therapy group were longer than those in control group, with statistical significances (χ2=5.496, P=0.026; χ2=4.540, P=0.046), while the 1, 2 years progressionfree survival rates of patients in the two groups were no statistical significances (χ2=2.034, P=0.182; χ2=0.091, P=0.395). Adverse reactions such as hemorrhage (4.94% vs 6.41%), thrombocytopenia (9.88% vs 8.98%), skin necrosis incidence (3.70% vs 1.28%) in the anticoagulant therapy group and control group were no statistical significances (χ2=0.516, P=0.685; χ2=0.008, P=1.000; χ2=0.847, P=0.632).ConclusionFor patients with NSCLC, prophylactic anticoagulant therapy can improve coagulation status, reduce the incidence of thrombosis, prolong OS, and no obvious adverse reactions.