紫杉醇联合顺铂化疗和低分子肝素钠治疗老年非小细胞肺癌患者的效果

Effect of paclitaxel plus cisplatin chemotherapy combined with low molecular weight heparin sodium on elderly patients with non-small cell lung cancer

目的探讨紫杉醇联合顺铂(TP)化疗和低分子肝素钠治疗老年非小细胞肺癌患者的效果。方法选择2014年4月至2017年12月在扬州友好医院和江南大学附属医院就诊的老年非小细胞肺癌患者120例,按照随机数字表法分为观察组和对照组,各60例。对照组给予TP化疗方案治疗,观察组在对照组基础上给予低分子肝素钠治疗,3周为1个疗程,治疗4个疗程。比较2组患者疗效和治疗前后肿瘤标志物、D-二聚体水平、生存质量以及不良反应发生情况。结果观察组总缓解率明显高于对照组[93. 3%(56/60)比83.30%(50/60)],差异有统计学意义(P=0. 032)。治疗后2组患者癌胚抗原、糖类抗原125、细胞角蛋白21-1片段及D-二聚体水平均明显低于治疗前,且观察组明显低于对照组,差异均有统计学意义(均P <0.05)。治疗后观察组生存质量评分与对照组比较明显改善,差异均有统计学意义(均P <0.05)。观察组不良反应发生率明显低于对照组[6.7%(4/60)比25.0%(15/60)],差异有统计学意义(P <0.05)。结论 TP化疗联合低分子肝素钠治疗老年非小细胞肺癌效果较好,同时能够降低血清肿瘤标志物、血浆D-二聚体水平,改善患者生存质量,降低不良反应发生率。

Objective To explore the effect of paclitaxel plus cisplatin（TP） chemotherapy combined with low molecular weight heparin sodium on elderly patients with non-small cell lung cancer. Methods A total of 120 elderly patients with non-small cell lung cancer were enrolled from April 2014 to December 2017 in Yangzhou Friendship Hospital and Affiliated Hospital of Jiangnan University. They were randomly divided into observation group and control group, with 60 cases in each group. The control group was treated with TP chemotherapy; the observation group was treated with TP chemotherapy and low molecular weight heparin. After 4 courses of treatment（1 course was 3 weeks）, clinical efficacy, tumor markers, D-dimer, quality of life and adverse reactions were analyzed. Results The total remission rate in the observation group was significantly higher than that in the control group[93.3%（56/60） vs 83.3%（50/60）]（P=0.032）. After treatment, carcinoembryonic antigen, cancer antigen 125, cytokeratin fragment antigen 21-1 and D-dimer were significantly lower than those before treatment; the levels in the observation group were significantly lower than those in the control group（P〈0.05）. After treatment, the score of life quality in the observation group was significantly improved compared to that in the control group（P〈0.05）. Incidence of adverse reactions in the observation group was significantly lower than that in the control group[6.7%（4/60） vs 25.0%（15/60）]（P〈0.05）. Conclusion TP chemotherapy combined with low molecular weight heparin treating elderly patients with non-small cell lung cancer can effectively improve the efficacy, lower serum levels of tumor markers and D-dimer, improve quality of life and reduce adverse reactions.