张念海

福建医科大学附属第一医院化疗科二区，福建福州　350004

低分子肝素联合化疗治疗高凝状态晚期直肠癌对血栓标志物的影响研究

张念海

福建医科大学附属第一医院化疗科二区，福建福州350004

目的 探讨高凝状态晚期直肠癌患者采取低分子肝素联合化疗治疗对血栓标志物的影响。方法 整群选取68例于2014年5月—2015年5月期间该院接收的伴高凝状态晚期直肠癌患者，根据治疗方案不同分为对照组（单纯化疗，n=34）与实验组（低分子肝素联合化疗，n=34），观察两组疗效及两组患者纤维蛋白水平、D-二聚体含量在治疗前后的变化。结果 实验组较对照组临床有效率稍高（P＞0.05），分别为70.6%、64.7%，差异无统计学意义；治疗后，对照组纤维蛋白原水平无变化，D-二聚体含量较疗前显著要高（P＜0.05），分别为（4.96±1.42）、（0.68±0.22）μg/L，实验组治疗后纤维蛋白原水平较疗前显著要低（P＜0.05），D-二聚体水平疗后显著降低（P＜0.05），分别为（3.63±0.72）、（0.28±0.16）μg/L，与对照组比较均差异有统计学意义；两组骨髓抑制、消化道反应情况比较差异无统计学意义（P＞0.05）。结论 高凝状态的晚期直肠癌患者采用低分子肝素联合化疗治疗，能有效改善患者高凝状态，但对直肠癌的远期疗效尚需进一步研究观察。

血栓标志物；高凝状态；低分子肝素；晚期直肠癌

［Abstract］Objective To study the clinical effect of low molecular weight heparin and chemotherapy in the thrombosis marker for patients with advanced rectal carcinoma and hypercoagulability.Methods Group selection 68 patients with advanced rectal carcinoma and hypercoagulability treated from May 2014 to May 2015 in our hospital were selected.The subjects were divided into two groups according to different therapies，34 cases each group.The control group took the chemotherapy；the test group took the low molecular weight heparin and chemotherapy.The clinical effect，the level of fibrinogen and D-dimer for two groups was observed.Results The clinical effective rate for test group（70.6%）was slightly higher than control group（64.7%）（P＞0.05）；For control group，the level of fibrinogen and D-dimmer was（4.96±1.42）g/L and（0.68±0.22）μg/L.The level of fibrinogen before and after treatment was not significantly different；the content of D-dimer was significantly higher than before（P＜0.05）.For test group，the level of fibrinogen and D-dimmer was（3.63±0.72）g/L and（0.28±0.16）μg/L.After treatment，the level of fibrinogen and D-dimer was significantly lower than before（P＜0.05）；the incidence rate of bone marrow suppression and gastrointestinal reaction for two groups was not significantly different（P＞0.05）.Conclusion For patients with advanced rectal carcinoma and hypercoagulability，the low molecular weight heparin and chemotherapy can improve the patient's hypercoagulability.However，the long-term effect shall be further explored.

［Key words］Thrombosis marker；Hypercoagulability；Low molecular weight heparin；Advanced rectal carcinoma

直肠癌随临床分期的增高，可呈高凝状态，血栓性疾病发生风险较大。而研究认为高凝状态与肿瘤预后不良、转移有关［1］。晚期直肠癌治疗以化疗疗法为主，但被认为是血栓形成发展的重要危险因子。为此，该文于2014年5月—2015年5月期间对68例伴高凝状态晚期的直肠癌患者资料进行回顾性分析，探讨高凝状态的晚期直肠癌患者采取低分子肝素联合化疗治疗的疗效及对血栓标志物的影响，现报道如下。……