斑蝥酸钠维生素B_6注射液对晚期贲门癌患者化疗后血浆D-二聚体含量的影响

Effect of Disodium Cantharidinate and Vitamin B6 Injection Combined with Chemotherapy on Plasma D-dimer Level in Patients with Advanced Cardia Cancer

目的研究晚期贲门癌患者血浆D-二聚体表达情况,探讨斑蝥酸钠维生素B6注射液联合化疗对晚期贲门癌患者血浆D-二聚体含量的影响。方法将临床病理证实且评估为不可手术的贲门癌患者62例随机分为两组:实验组(A组)接受PF方案化疗(至少4周期),随化疗同时给予斑蝥酸钠维生素B6注射液,每日0.5 mg;对照组(B组)接受同样方案化疗,同时给予等量0.9%氯化钠溶液。62例贲门癌患者分别于初次化疗前1天和第三次化疗前1天,抽取静脉血行D-二聚体测定。结果晚期贲门癌患者化疗前血浆D-二聚体含量在不同的性别、年龄、病理类型及临床分期各组比较差异无统计学意义(P>0.05)。化疗后D-二聚体水平较化疗前明显降低(P=0.000),且实验组(A组)患者化疗后血浆D-二聚体含量明显低于对照组(B组)患者(P=0.042)。消化道不良反应发生率比较,两组间差异无统计学意义(48.4%vs.64.5%,P=0.200),血液毒性发生率A组较B组明显降低(41.9%vs.67.7%,P=0.041)。结论晚期贲门癌患者化疗后血浆D-二聚体含量明显下降。斑蝥酸钠维生素B6注射液对于贲门癌患者的化疗产生了较为明显的协同作用,且有效地降低了化疗不良反应,减轻了晚期贲门癌患者血栓发生的风险。

Objective To explore the expression of plasma D-dimer in patients with advanced cardia cancer and the effect of disodium cantharidinate and vitamin B6 injection combined with chemotherapy on plasma D-dimer level. Methods Sixty-two advanced cardia cancer patients confirmed by pathological examination were randomly divided into two groups, 31 patients in experimental group(Group A) received PF chemotherapy(4 cycles at least) combined with disodium cantharidinate and vitamin B6 injection(0.5 mg/d), and other 31 patients in control group(Group B) received the same generation chemotherapy but combined with equivalent saline. The D-dimer level was determined one day before the first and third chemotherapy. Results There was no statistical significance of plasma D-dimer level in different gender, age, pathological types or clinical stage in advanced cardia cancer patients before chemotherapy among all groups(P>0.05). D-dimer level was significantly decreased after chemotherapy(P=0.000), moreover, D-dimer level after chemotherapy in Group A was significantly lower than that in Group B(P=0.042). The ratio of gastrointestinal disorders in Group A(48.4%) was no difference with that in Group B(64.5%)(P=0.200). Moreover, the ratio of blood system disorders in Group A(41.9%) was lower than that in Group B(67.7%, P=0.041). Conclusion After chemotherapy, plasma D-dimer level in advanced cardia cancer patients was significantly decreased. Disodium cantharidinate and vitamin B6 injection could be the co-effective drug with chemotherapy and reduce the adverse events of chemotherapy and the risk of thrombus in advanced cardia cancer patients.