复方苦参注射液联合吉非替尼对晚期非小细胞肺腺癌患者高凝状态的影响研究

Effects of Compound Kushen Injection Combined with Gefitinib on Hypercoagulable State in Patients with Advanced Non-Small Cell Lung Adenocarcinoma

目的:探讨复方苦参注射液联合吉非替尼对晚期非小细胞肺腺癌高凝状态的干预情况。方法:将2018年6月至2021年5月辽阳市中心医院收治的90例经生化报告为高凝状态的非小细胞肺腺癌患者随机分为观察组和对照组,各45例。两组患者均应用吉非替尼干预,观察组患者加用复方苦参注射液,以2周(14 d)为1个疗程,两组患者均治疗4个疗程。观察两组患者治疗前后的凝血功能指标[血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)]变化、凝血代谢产物[D-二聚体、纤维蛋白降解产物(FDP)、血小板计数(PLT)、血小板压积(PCT)和血小板聚集率(PAg)]变化、血流动力学指标(红细胞聚集指数、红细胞压积、毛细管血浆黏度、全血低切黏度和全血高切黏度)变化,记录不良反应发生情况。结果:经过治疗,观察组患者的PT、APTT和FIB水平较对照组升高,TT较对照组缩短,经比较两组患者APTT、TT的差异有统计学意义(P<0.05);观察组患者的D-二聚体、FDP、PLT、PCT和PAg水平较对照组降低,经比较两组患者D-二聚体、FDP和PAg水平的差异有统计学意义(P<0.05);观察组患者血流动力学指标(红细胞聚集指数、红细胞压积、毛细管血浆黏度、全血低切黏度和全血高切黏度)水平较对照组明显降低,差异有统计学意义(P<0.05)。观察组患者的不良反应发生率为11.1%(5/45),明显低于对照组的31.1%(14/45),差异有统计学意义(P<0.05)。结论:处于高凝状态的非小细胞肺腺癌患者,经过复方苦参注射液联合吉非替尼治疗疗效显著,且可改善非小细胞肺腺癌患者的高凝状态。

OBJECTIVE:To explore the intervention of compound Kushen injection combined with gefitinib on hypercoagulable state in patients with advanced non-small cell lung adenocarcinoma.METHODS:Ninety patients with non-small cell lung adenocarcinoma who were biochemical reported as hypercoagulable state in Center Hospital of Liaoyang from Jun.2018 to May 2021 were randomly divided into the observation group and the control group,with 45 cases in each group.Patients in the two groups were treated with gefitinib,the observation group was given compound Kushen injection for 2 weeks(14 d)as a course,and both groups were treated with 4 courses.Coagulation changes[plasma prothrombin time(PT),activated partial thromboplastin time(APTT),prothrombin time(TT)and fibrinogen(FIB)],coagulation metabolite changes[D-dimer,fibrin degradation product(FDP),platelet count(PLT),platelet pressure product(PCT)and platelet aggregation rate(PAg)],hemodynamic indicators(erythrocyte aggregation indicator,hematocrit,capillary plasma viscosity,whole blood viscosity low shearing and whole blood viscosity high shearing)before and after treatment in two groups were observed,the incidence of adverse drug reactions was recorded.RESULTS:After treatment,the PT,APTT and FIB levels in the observation group were higher than those in the control group,while the TT in the observation group was shorter than that in the control group,and there were significant differences in the levels of APTT,TT between the two groups(P<0.05);the levels of D-dimer,FDP,PLT,PCT and PAg in the observation group were lower than those in the control group,and there were significant differences in the levels of D-dimer,FDP and PAg between the two groups(P<0.05);the hemodynamic indicators(erythrocyte aggregation indicator,hematocrit,capillary plasma viscosity,whole blood viscosity low shearing and whole blood viscosity high shearing)of the observation group were significantly lower than the control group,the differences were statistically significant(P<0.05).The incidence of adverse drug reactions in the observation group was 11.1%(5/45),significantly lower than 31.1%(14/45)in the control group,with statistically significant differences(P<0.05).CONCLUSIONS:For patients with non-small cell lung adenocarcinoma in hypercoagulable state,the combination of compound Kushen injection and gefitinib has significant therapeutic effect,and can improve the hypercoagulability of patients with non-small cell lung adenocarcinoma.