【摘要】 目的:探讨小分子靶向药物吉非替尼对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的凝血功能及疗效的影响。方法:随机选取2017年8月至2018年8月北京市大兴区人民医院收治的晚期NSCLC患者60例作为观察组,采用吉非替尼治疗;选取同期60例健康体检者作为对照组。比较观察组患者治疗前后及其与对照组人群凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、凝血活酶时间(APTT)、D-二聚体(D-D)、纤维蛋白原(FIB)、血小板计数(PLT)、血小板比容(PCT)、血小板分布宽度(PDW)、平均血小板体积(MPV)及血小板比率(P-LCR)]水平的差异;统计观察组患者的临床疗效、不良事件发生情况。结果:观察组患者的TT、PT及APTT明显长于对照组,D-D、FIB、PLT及PCT水平明显高于对照组,PDW、MPV及P-LCR水平明显低于对照组,差异均有统计学意义(P<0.05)。与治疗前比较,治疗后,观察组患者的PT明显延长,D-D、FIB及PLT水平明显升高,APTT、TT明显缩短,PDW、MPV、PCT及P-LCR水平明显降低,上述差异均有统计学意义(P<0.05)。观察组患者的疾病控制率为93.33%(56/60);3例患者发生静脉血栓,不良事件发生率为5.00%。结论:晚期NSCLC患者的凝血功能多存在异常,经过吉非替尼治疗后,其凝血功能异常程度会加剧,有进一步增加静脉血栓形成的风险。更多还原

【Abstract】 OBJECTIVE: To probe into the effects of molecular targeted drug of gefitinib in treatment of non-small cell lung cancer(NSCLC) on coagulation function and efficacy. METHODS: 60 patients with advanced NSCLC admitted into Peolple’s Hospital of Beijing Daxing District from Aug. 2017 to Aug. 2018 were selected as observation group, which was treated with gefitinib; while 60 healthy controls at the same term were selected as control group. Differences in indices of coagulation function [thrombin time(TT), prothrombin time(PT), activated partial thromboplastin time(APTT), D-dimer(DD), fibrinogen(FIB), platelet count(PLT), thrombocytocrit(PCT), platelet distribution width(PDW), mean platelet volume(MPV) and platelet-large contrast ratio(P-LCR)] between before and after treatment of the observation group and control group were compared; the efficacy and incidences of adverse drug reactions in observation group was observed. RESULTS: The TT, PT and APTT of observation group was significantly longer than those of the control group, the D-D,FIB,PLT and PCT levels were significantly higher than those of the control group,while the PDW,MPV and P-LCR levels were significantly lower than those of the control group,with statistically significant differences(P<0.05). Compared with before treatment, after treatment, the PT of observation group had been significantly prolonged, with significantly higher D-D, FIB and PLT levels, the APTT and TT had been significantly shortened, levels of PDW, MPV, PCT and P-LCR were significantly lower, with statistically significant differences(P<0.05). The disease control rate of observation group was 93.33%(56/60); venous thrombosis occurred in 3 patients, with the incidence of adverse events was 5.00%. CONCLUSIONS: The coagulation function of patients with advanced NSCLC is abnormal, which could be aggravated after the treatment of gefitinib and has the risk in further increase of venous thrombosis.更多还原