2020 年第 10 期 第 15 卷

阿司匹林对肺癌放化疗患者静脉血栓栓塞症的防治效果

Efficacy of aspirin in prevention and treatment of venous thromboembolism in patients with lung cancer radiochemotherapy

作者：胡安祥1朱正秋2

英文作者：Hu Anxiang1 Zhu Zhengqiu2

单位：1徐州医科大学附属滕州医院肿瘤二科277599；2徐州医科大学附属医院东院区肿瘤科三病区221131

英文单位：1The Second Department of Tumor Tengzhou Hospital Affiliated to Xuzhou Medical University Tengzhou 277599 China； 2Third Ward Department of Oncology East Branch the Affiliated Hospital of Xuzhou Medical University Xuzhou 221131 China

关键词：肺癌；阿司匹林；放化疗；静脉血栓栓塞症

英文关键词：ungcancer;Aspirin;Radiochemotherapy;Venousthromboembolism

• 摘要：

• 目的 探讨阿司匹林对肺癌放化疗患者静脉血栓栓塞症（VTE）的防治效果。方法 选取徐州医科大学附属滕州医院2017年1月至2019年12月收治的120例肺癌患者，根据随机数字表法分为对照组和观察组，各60例。对照组常规接受放化疗；观察组在对照组基础上联合阿司匹林治疗；21 d为1个疗程，2组均治疗2个疗程。比较2组患者治疗期间VTE发生率，治疗前和治疗1、2个疗程后的Karnofsky功能状态评分,治疗期间出血发生率，以及治疗前后凝血功能的变化。结果 治疗期间，观察组VTE发生率低于对照组［6.7%(4/60)比28.3%（17/60）］（P<0.05），出血发生率与对照组比较差异无统计学意义（P＞0.05）。治疗前2组Karnofsky功能状态评分比较差异无统计学意义（P>0.05）；治疗1、2个疗程后，2组Karnofsky功能状态评分均明显高于本组治疗前，且观察组均高于对照组［(82.4±4.2)分比（75.7±8.1）分，(88.4±2.5)分比（82.2±9.6）分］（均P<0.05）。治疗前2组凝血功能指标水平比较差异均无统计学意义（均P>0.05）；治疗后，2组D-二聚体、纤维蛋白原、血小板计数、血小板最大聚集率水平均低于治疗前，且观察组均低于对照组；凝血酶原时间、活化部分凝血活酶时间均长于治疗前，且观察组均长于对照组（均P＜0.05）。结论 阿司匹林可有效改善肺癌放化疗患者高凝状态，降低VTE发生率，提高生活质量，且不增加出血风险。

• Objective To investigate the preventive and therapeutic effect of aspirin on venous thromboembolism (VTE) in patients with lung cancer undergoing radiochemotherapy. Methods A total of 120 patients with chemotherapy for lung cancer admitted to Tengzhou Hospital Affiliated to Xuzhou Medical University from January 2017 to December 2019 were selected. According to the random number method, the patients were divided into control group and observation group, with 60 cases in each group. The control group received radiochemotherapy alone. The observation group was treated with aspirin on the basis of the control group. Twenty-one days was a course of treatment, and both groups were treated for 2 courses. The incidence of VTE during treatment, the Karnofsky (KPS) score before and 1， 2 courses after treatment, the incidence of bleeding during treatment and the indicators related to coagulation function before and after treatment were compared between the two groups. Results After 2 courses of treatment, the incidence of VTE in the observation group was lower than that in the control group ［6.7%(4/60) vs 28.3% (17/60)］(P<0.05). There was no significant difference in the incidence of bleeding between the two groups (P>0.05). There was no statistically significant difference in KPS score between the two groups before treatment (P>0.05). After 1 and 2 courses of treatment, the KPS score in both groups were significantly higher than those before treatment, and the KPS score in the observation group were significantly higher than those in the control group［(82.4±4.2) vs （75.7±8.1），(88.4±2.5) vs （82.2±9.6）］ (all P<0.05). There was no statistically significant difference in the levels of coagulation function indexes between the two groups before treatment (all P>0.05). After treatment, the levels of D-dimer, fibrinogen, platelet count and maximum platelet aggregation rate in the two groups were all lower than those before treatment, and these levels in the observation group were all lower than those in the control group (all P<0.05). The levels of prothrombin time and activated partial thromboplastin time in the two groups were both longer than those before treatment, and these levels in the observation group were longer than those in the control group (all P<0.05). Conclusion Aspirin can effectively improve the hypercoagulable state in patients receiving radiochemotherapy for lung cancer, reduce the incidence of thrombosis, the effect is significant, and does not increase the risk of bleeding.