聂翔

[摘要] 目的 探讨血浆D-二聚体在中晚期肺癌化疗中的临床价值。 方法 选取2017年8月至2019年8月我院30例不能手术的中晚期肺癌患者，进行相关化疗治疗，检测化疗前后患者的血浆D-二聚体水平。观察比较化疗前后患者D-二聚体水平、不同化疗效果患者D-二聚体水平以及不同分期患者D-二聚体水平。 结果 化疗后，中晚期肺癌患者的D-二聚体水平较化疗前明显降低，差异有统计学意义（P<0.05）。随着实体瘤的下降，D-二聚体水平随之下降，差异有统计学意义（P<0.05）。Ⅳ期患者的D-二聚体水平较Ⅲ期明显更高，差异有统计学意义（P<0.05）。 结论 在中晚期肺癌化疗中，通过检测血浆D-二聚体可以了解肿瘤分期和患者病情的变化，化疗效果越差、分期越晚，血浆D-二聚体水平越高。

[关键词] 血浆D-二聚体;中晚期肺癌;化疗;肿瘤分期;高凝状态;凝血系统

[中图分类号] R446.11          [文献标识码] B          [文章编号] 1673-9701（2021）16-0096-03

Clinical value of plasma D-dimer in chemotherapy of advanced lung cancer

NIE Xiang

Department of Oncology， Jingdezhen First People′s Hospital in Jiangxi Province， Jingdezhen   333000， China

[Abstract] Objective To explore the clinical value of plasma D-dimer in chemotherapy of advanced lung cancer. Methods A total of 30 inoperable patients with advanced lung cancer in our hospital from August 2017 to August 2019 were selected for relevant chemotherapy. The D-dimer level of patients before and after chemotherapy was detected. The plasma D-dimer in patients before and after chemotherapy， in patients with different chemotherapy effects and with different stages were observed and compared. Results The level of D-dimer in patients with advanced lung cancer after chemotherapy was significantly lower than before chemotherapy， and the difference was statistically significant （P<0.05）. With the decline of solid tumors， the level of D-dimer decreased， and the difference was statistically significant （P<0.05）. The level of D-dimer in stage Ⅳ patients was significantly higher than that in stage Ⅲ， and the difference was statistically significant （P<0.05）. Conclusion In the chemotherapy of advanced lung cancer， the changes in tumor stage and patient's condition can be understood by detecting plasma D-dimer. The worse the chemotherapy effect and the later the stage，the higher the plasma D-dimer level.

[Key words] Plasma D-dimer; Advanced lung cancer; Chemotherapy; Tumor staging; Hypercoagulable state; Coagulation system

肺癌位居所有惡性肿瘤发病率、死亡人数之首，全球发病率最高，病死率也极高，且男性发病率高于女性，大约是女性的3倍[1]。世界范围内每年肺癌新发大约180万，死亡160万。肺癌也是发病率和死亡率增长最快的一种恶性肿瘤，严重威胁患者的生命健康。我国每年肺癌新发大约73万，死亡大约60万。近年来，随着空气污染的加剧、工业化进程的加快、社会环境的变化，肺癌的发病率不断上升。肺癌中大部分为非小细胞肺癌，大约占80%，其余为小细胞肺癌[2]。大约75%的非小细胞肺癌患者发现病情时已经处于中晚期，错过最佳治疗时机，导致病情恶化，5 年生存率极低。中晚期肺癌患者的治疗方法主要以化疗为主。肺癌患者存在血液高凝状态，作为继发性纤溶的一个特异性指标，血浆D-二聚体的变化与患者的病情发展、预后相关，因此对评价化疗的疗效有重要的意义。本研究选取30例肺癌患者，探讨血浆D-二聚体在中晚期肺癌化疗中的临床价值，现报道如下。……