低分子肝素钠预防性抗凝治疗非小细胞肺癌的临床观察

摘要

目的：观察非小细胞肺癌（ NSCLC）患者化疗后血浆D－二聚体水平的变化，探讨低分子肝素钠预防性抗凝治疗对血浆D－二聚体的影响及其与化疗疗效的关系。方法将120例NSCLC患者采用随机数字表法分为对照组与治疗组，对照组给予常规化疗，治疗组在常规化疗的基础上给予低分子肝素钠预防性抗凝治疗。检测2组患者血浆D－二聚体的变化及其与临床疗效的关系。结果与化疗前相比，化疗结束后对照组血浆D－二聚体水平略微升高，治疗组血浆D－二聚体水平明显降低，差异有统计学意义（ P＜0．01）。治疗组总有效率为667．6％，明显高于对照组46．7％，差异有统计学意义（ P＜0．05）。 D－二聚体水平与临床疗效呈负相关。治疗组27例患者治疗后生存质量明显提高。结论血浆D－二聚体水平可作为化疗疗效的观察指标，低分子肝素钠抗凝治疗可提高化疗疗效，改善NSCLC患者生存质量。%Objectiv e To observe the changes in plasma D-dimer after chemotherapy in patients with non-small cell lung cancer ( NSCLC) , and to investigate the effects of prophylactic anticoagulation therapy with low-molecular-weight heparin sodium on plasma D-dimer and its relationship with chemotherapy efficacy.Methods A total of 120 NSCLC patients were randomly divided into a control group and a treatment group.The control group received routine chemotherapy, while the treatment group was provided with prophylactic therapy using low-molecular-weight heparin sodium in addition to routine chemotherapy.The levels of D-dimer in both groups were detected before and after treat-ment, and its association with clinical efficacy was examined.Results After chemotherapy, the level of D-dimer was slightly elevated in the control group but remarkably reduced in the treatment ( P<0.01 ) .The total efficient rate was 65.6%(40/60) , which was statistically different from 46.7%(28/60) of the control ( P<0.05) .The level of D-di-mer was negatively associated with clinical efficacy , r=-0.973, P<0.05.There were 27 patients in the treatment group presented markedly improved quality of life,χ2 =9.43, P=0.002.Conclusion The level of plasma D-dimer can be used as an observation index to assess chemotherapy efficacy.Prophylactic anticoagulation therapy with low-mo-lecular-weight heparin sodium can improve both chemotherapy efficacy and quality of life of NSCLC patients.