论文部分内容阅读
目的观察晚期肺癌患者化疗前后凝血、纤溶系统变化情况及低分子质量肝素钙对其的干预效果。方法 80例晚期肺癌化疗患者,随机分为观察组40例和对照组40例。对照组进行GP方案或NP方案化疗;观察组在对照组基础上再给予低分子质量肝素钙,至化疗结束;28 d为1个周期,化疗2个周期。治疗前后空腹抽静脉血,采用全自动血凝仪检测凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶凝固时间(TT)及血浆纤维蛋白原(Fbg),采用ELISA法检测D-二聚体(D-D),采用发色底物法测定血浆组织纤溶酶原激活剂(t-PA)、纤溶酶原激活剂抑制物(PAI)。采用SPSS 17.0统计软件对计量资料进行进行t检验,P<0.05为差异有统计学意义。结果与治疗前比较,对照组治疗后Fbg、D-D增高,PT、APTT、TT降低,差异有统计学意义(P<0.05),t-PA、PAI变化不明显,差异无统计学意义(P>0.05);观察组治疗后PAI降低,t-PA增高,差异有统计学意义(P<0.05)。观察组治疗后Fbg、D-D、PAI低于对照组,PT、APTT、TT、t-PA高于对照组,差异有统计学意义(P<0.05)。结论化疗可加重晚期肺癌患者的凝血-纤溶功能异常及血栓前状态,使凝血功能异常;低分子质量肝素钙能够有效抗凝及抑制血栓形成。
Objective To observe the changes of coagulation and fibrinolysis system in patients with advanced lung cancer before and after chemotherapy and the effect of low molecular weight heparin calcium intervention. Methods Eighty patients with advanced lung cancer were randomly divided into observation group (40 cases) and control group (40 cases). The control group was treated with GP regimen or NP regimen. The observation group was given low-molecular-weight heparin calcium on the basis of the control group until the end of chemotherapy; 28 days was 1 cycle and 2 cycles of chemotherapy. Fasting venous blood was collected before and after treatment. Prothrombin time (PT), partial thromboplastin time (APTT), thrombin clotting time (TT) and fibrinogen fibrinogen (Fbg) D-dimer (DD) was detected and plasma tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) were measured by chromogenic substrate method. Using SPSS 17.0 statistical software to measure the data for t test, P <0.05 for the difference was statistically significant. Results Compared with those before treatment, the levels of Fbg, DD, PT, APTT and TT in the control group were significantly decreased (P <0.05), while the changes of t-PA and PAI in the control group were not significantly different (P> 0.05). After treatment, PAI decreased and t-PA increased in the observation group, with statistical significance (P <0.05). The Fbg, D-D and PAI in the observation group were lower than those in the control group, while PT, APTT, TT and t-PA were higher in the observation group than in the control group (P <0.05). Conclusion Chemotherapy can aggravate coagulation-fibrinolytic dysfunction and prothrombotic state in patients with advanced lung cancer and make coagulation dysfunction. Low-molecular weight heparin calcium can effectively anticoagulant and inhibit thrombosis.