不同化疗方案对非小细胞肺癌患者凝血纤溶功能及血小板参数的影响及其临床意义

The Effect and Clinical Significances of Different Chemotherapy Methods on the Blood Coagulation and Fibrinolytic Function of NSCLC Patients

目的:探讨不同化疗方案对非小细胞肺癌患者凝血纤溶功能及血小板参数的影响及临床意义。方法:回顾性分析2013年2月至2016年2月于我院进行治疗的96非小细胞肺癌患者的临床资料,按照化疗方案的不同分为TP组(50例)及GP组(46例),TP组患者给予多西他赛联合卡铂方案(TP方案)进行化疗,GP组患者给予吉西他滨联合卡铂方案(GP方案)进行化疗,另选择45例健康体检者作为对照组。比较三组治疗前者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)、血浆纤维蛋白原含量(FIB)以及D-二聚体(D-dimer)、血小板数(PLT)、血小板比积(PCT)、血小板平均体积(MPV)、血小板体积分布宽度(PDW)以及大体积血小板比率(P-LCR)及TP组和GP组治疗后以上指标的差异。结果:TP组和GP组患者化疗前PT、APTT、TT、FIB、D-dimer、PLT、PCT、MPV、PDW以及P-LCR水平均明显高于对照组(P<0.05),而TP组与GP组以上指标比较无显著差异(P>0.05)。治疗后,TP组和GP组患者PT、APTT、TT、FIB、D-dimer、PLT、PCT、MPV、PDW以及P-LCR水平均较治疗前有所下降,且GP组TT明显长于TP组(P<0.05),PLT、PCT明显低于TP组(P<0.05)。结论:凝血纤溶功能及血小板参数对于评价不同化疗方案治疗非小细胞肺癌患者预后具有积极的临床价值,不同化疗方案选择对于患者凝血系统均具有一定的影响。

Objective： To explore the clinical value and clinical significances of blood coagulation and fibrinolytic fuction and platelet parameters changing on non-small cell lung cancer using different chemotherapy methods. Methods： 96 patients with non-small cell lung cancer accepted in our hospital from Feb.2013 to Feb.2016 were retrospectively anlyzed and divided into TP group with 50 cases and GP group with 46 cases according to the different chemotherapy methods. Patients in TP group were given Taxotere combined with Carboplatin, patients in GP group were given Gemcitabine combined with Carboplatin.Another 45 cases who took health examination were selected as control group. Then the coagulation and fibrinolytic function （PT, APTT, TT, FIB and D-dimer） and platelet parameters （PLT, PCT, MPV, PDW and P-LCR） of two groups were analyzed and compared. Results： Before chemotherapy, the blood coagulation and fibrinolytic function and platelet parameters of lung cancer patients were obviously higher than control group （P〈0.05）, but the difference between TP group and GP group had no statistically significance （P〉0.05）. After treatment, the indexes of coagulation and fibrinolytic function and platelet paramenters were decreasing than before, and TT of GP group was longer than TP group with statistically significance （P〈0.05）. Besides, the platelet parameters were decreasing and the GP group had a better decresing trend than TP group （P〈0.05）. Conclusion： Blood coagulation and fibrinolytic function and platelet parameters changing have positive diagnostic value in the treatment and prognostic judgement of non-small cell lung cancer. Different methods of chemotherapy can have different effect on the coagulation and fibrinolytic function of patients, which is worthy of particular mention.