低分子肝素作用于NSCLC的临床疗效及对患者凝血功能的影响

目的 探讨低分子肝素作用于非小细胞肺癌(NSCLC)的临床疗效及对患者凝血功能的影响.方法 使用前瞻性临床研究的方法,随机选取Ⅲ期和Ⅳ期的NSCLC患者140例,通过随机分组法,分为2组.A组为研究组70例,B组为参照组70例.B组采用一线化疗和常规对症治疗方案,A组在B组方案上,采用低分子肝素(LMWH)抗凝治疗.对A、B组治疗结果进行对比分析.结果 A、B组治疗前KPS分别为(78.25±9.62)和(82.25±7.29),差异无统计学意义(P=0.335).A组治疗前后KPS评分对比,差异无统计学意义(P =0.061);B组治疗前后KPS评分对比,差异有统计学意义(P =0.008);2组治疗后KPS对比,差异有统计学意义(P =0.002).2组患者凝血指标和正常相比,都表现出不同程度的异常.A组患者治疗前后的凝血指标对比中,TT、Fib、D-D及PLT差异有统计学意义(P =0.002;P=0.001;P =0.014;P =0.004),APTT、PT差异无统计学意义(P =0.128;P =0.065);B组患者治疗前后的凝血指标对比中,D-D、PLT差异有统计学意义(P=0.034;P=0.004),APTT、PT、TTT及Fib差异无意义(P=0.119;P=0.139;P=0.532;P =0.431).治疗前2组患者凝血指标对比差异无统计学意义(P＞0.05);治疗后TTT、Fib、D-D、PLT方面差异有统计学意义(P=0.007;P=0.017;P=0.034;P=0.001),而在APPT、PT差异无统计学意义(P =0.838;P =0.250).治疗2周期后,A组和B组总有效率分别为25.71％和17.14％,差异无统计学意义(P =0.371);A组和B组总控制率分别为91.43％和82.86％,差异无统计学意义(P =0.459).2组抗癌药物的不良反应发生率差异均无统计学意义(P＞0.05).结论 LMWH在治疗NSCLC患者时可以有效改善患者的异常凝血功能指标,同时有效地改善了化疗对患者生活质量的影响.

Effect of Low Molecular Weight Heparin on Coagulation Parameters in Patients with NSCLC and Clinical Efficacy Analysis

Objective To investigate the effect of low molecular weight heparin in patients with coagulation function changes and clinical efficacy in non-small cell lung cancer (NSCLC).Methods A prospective clinical study method were used,140 cases of stage Ⅲ and Ⅳ NSCLC patients were randomly divided into 2 groups,each with 70 cases.Group A was the study group,group B was the control group.Group B received first-line chemotherapy and conventional symptomatic treatment,group A received low molecular weight heparin (LMWH) anticoagulation therapy on the basis of group B,treatment results of the 2 groups were analyzed.Results KPS score of group A and B before treatment were (78.25 ± 9.62) and (82.25 ± 7.29),A,B groups of patients before treatment KPS score had no significant difference (P =0.335).Coagulation parameters of the 2 groups and normal patients had shown different degrees of abnormality.The comparison between before and after the coagulation treatment of patients in group A,TF,Fib,DD and PLT were significant (P =0.002;P =0.001;P =0.014;P =0.004),APTT,PT were insignificant (P =0.128;P =0.065);the comparison between before and after clotting in patients in group B,DD,PLT were significant (P =0.034;P =0.004),APTT,PT,TT and Fib four indexes were insignificant (P =0.119;P =0.139;P =0.532;P =0.431);before treatment,coagulation indexes between the 2 groups had no significant difference (P ＞ 0.05);A,B groups among patients treated after coagulation contrast,TF,Fib,DD,PLT were significant (P =0.007;P =0.017;P =0.034;P =0.001),APPT,PT were insignificant (P =0.838;P =0.250).After 2 cycles of treatment,A,B groups had no CR cases,A group and B group the total effective rate was 25.71％ and 17.14％,there had no significant difference (P =0.371).A group and B group,the total rates were 91.43％ and 82.86％,respectively,there had no significant difference (P =0.459).KPS scores before and after treatment in group A had no significant ditference(P =0.061).KPS scores before and after treatment in group B had no significant difference (P =0.008).A,B groups after treatment comparison group,the difference was significant (P =0.002).A,B groups KPS score evaluation comparison,A group (increase + stable)to 60 cases (88.57％)than group B (increase + stable)to 40 cases (60.00％),the difference was significant (P =0.007).A,B groups anti-cancer drug reactions showed no significance (P ＞0.05).Conclusion LMWH in the treatment of NSCLC patients can effectively improve the patient's abnormal coagulation parameters,and effectively improve the effect of chemotherapy on the patient's quality of life.