红花黄色素注射液联合巴曲酶注射液治疗老年非小细胞肺癌并急性次大面积肺栓塞患者的临床疗效
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摘要
目的观察红花黄色素注射液联合巴曲酶注射液治疗老年非小细胞肺癌(NSCLC)并急性次大面积肺栓塞(ASPE)的临床疗效。方法选取2016年1月—2017年1月咸阳市第一人民医院收治的老年NSCLC并ASPE患者202例,采用随机数字表法分为对照组和治疗组,每组101例。在常规治疗基础上,对照组患者给予巴曲酶注射液治疗,治疗组在对照组基础上给予红花黄色素注射液治疗;两组患者均连续治疗14 d。比较两组患者临床疗效,治疗前后动脉血气分析指标、凝血功能指标、右心功能指标,观察两组患者治疗期间不良反应发生情况。结果治疗组患者临床疗效优于对照组(P<0.05)。治疗前两组患者动脉血二氧化碳分压(PaCO_2)、肺泡-动脉血氧分压差[P(A-a)O_2]、动脉血氧分压(PaO_2)比较,差异无统计学意义(P>0.05);治疗后治疗组患者PaCO_2、P(A-a)O_2低于对照组,PaO_2高于对照组(P<0.05)。治疗前两组患者D-二聚体、心肌肌钙蛋白Ⅰ(cTnⅠ)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)比较,差异无统计学意义(P>0.05);治疗后治疗组患者D-二聚体、cTnⅠ低于对照组,PT、APTT短于对照组(P<0.05)。治疗前两组患者右心房内径、右心房室瓣反流压差、肺动脉压及右心室内径比较,差异无统计学意义(P>0.05);治疗后治疗组患者右心房内径、右心室内径短于对照组,右房室瓣反流压差、肺动脉压低于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论红花黄色素注射液联合巴曲酶注射液治疗老年NSCLC并ASPE患者的临床疗效确切,可有效改善患者动脉血气指标、凝血功能、右心功能,且安全性较高。
Objective To observe the clinical effect of carthamin yellow injection combined with batroxobin injection on acute sub-massive pulmonary embolism(ASPE)in elderly patients with non-small cell lung cancer(NSCLC). Methods A total of 202 elderly NSCLC patients complicated with ASPE were selected in the First People's Hospital of Xianyang from January 2016 to January 2017,and they were divided into control group and treatment group according to random number table,each of 101 cases. Based on conventional treatment,patients in control group received batroxobin injection,while patients in treatment group received carthamin yellow injection combined with batroxobin injection;both groups continuously treated for 14 days. Clinical effect,arterial blood-gas analysis,index of blood coagulation function and right heart function before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results Clinical effect in treatment group was statistically significantly better than that in control group(P<0.05). No statistically significant differences of PaCO_2,P(A-a)O_2 or PaO_2 was found between the two groups before treatment(P>0.05);after treatment,PaCO_2 and P(A-a)O_2 in treatment group were statistically significantly lower than those in control group,while PaO_2 in treatment group was statistically significantly higher than that in control group(P<0.05). No statistically significant differences of D-dimer,cTnⅠ,PT or APTT was found between the two groups before treatment(P>0.05);after treatment,D-dimer and cTnⅠ in treatment group were statistically significantly lower than those in control group,meanwhile PT and APTT in treatment group were statistically significantly shorter than those in control group(P<0.05). No statistically significant differences of right atrial inner diameter,PGTI,pulmonary arterial pressure or right ventricle diameter was found between the two groups before treatment(P>0.05);after treatment,right atrial inner diameter and right ventricle diameter in treatment group were statistically significantly shorter than those in control group,meanwhile PGTI and pulmonary arterial pressure in treatment group were statistically significantly lower than those in control group(P<0.05). No statistically significant differences of incidence of adverse reactions was found between the two groups during treatment(P>0.05).Conclusion Carthamin yellow injection combined with batroxobin injection has certain clinical effect on ASPE in elderly patients with NSCLC,can effectively adjust the arterial blood-gas analysis,improve the blood coagulation function and right heart function,and is relatively safe.
Objective To observe the clinical effect of carthamin yellow injection combined with batroxobin injection on acute sub-massive pulmonary embolism(ASPE)in elderly patients with non-small cell lung cancer(NSCLC). Methods A total of 202 elderly NSCLC patients complicated with ASPE were selected in the First People's Hospital of Xianyang from January 2016 to January 2017,and they were divided into control group and treatment group according to random number table,each of 101 cases. Based on conventional treatment,patients in control group received batroxobin injection,while patients in treatment group received carthamin yellow injection combined with batroxobin injection;both groups continuously treated for 14 days. Clinical effect,arterial blood-gas analysis,index of blood coagulation function and right heart function before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during treatment. Results Clinical effect in treatment group was statistically significantly better than that in control group(P<0.05). No statistically significant differences of PaCO_2,P(A-a)O_2 or PaO_2 was found between the two groups before treatment(P>0.05);after treatment,PaCO_2 and P(A-a)O_2 in treatment group were statistically significantly lower than those in control group,while PaO_2 in treatment group was statistically significantly higher than that in control group(P<0.05). No statistically significant differences of D-dimer,cTnⅠ,PT or APTT was found between the two groups before treatment(P>0.05);after treatment,D-dimer and cTnⅠ in treatment group were statistically significantly lower than those in control group,meanwhile PT and APTT in treatment group were statistically significantly shorter than those in control group(P<0.05). No statistically significant differences of right atrial inner diameter,PGTI,pulmonary arterial pressure or right ventricle diameter was found between the two groups before treatment(P>0.05);after treatment,right atrial inner diameter and right ventricle diameter in treatment group were statistically significantly shorter than those in control group,meanwhile PGTI and pulmonary arterial pressure in treatment group were statistically significantly lower than those in control group(P<0.05). No statistically significant differences of incidence of adverse reactions was found between the two groups during treatment(P>0.05).Conclusion Carthamin yellow injection combined with batroxobin injection has certain clinical effect on ASPE in elderly patients with NSCLC,can effectively adjust the arterial blood-gas analysis,improve the blood coagulation function and right heart function,and is relatively safe.
引文
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[12]吴升,杨丽华,梁梅恨.50例肺癌合并肺栓塞的临床诊治分析[J].临床肺科杂志,2016,21(2):335-337.DOI:10.3969/j.issn.1009-6663.2016.02.041.
[13]HU H M,CHEN L,FRARY C E,et al.The beneficial effect of batroxobin on blood loss reduction in spinal fusion surgery:a prospective,randomized,double-blind,placebo-controlled study[J].Arch Orthop Trauma Surg,2015,135(4):491-497.DOI:10.1007/s00402-015-2183-0.
[14]王峰.中西医结合治疗肺栓塞疗效分析[J].实用中西医结合临床,2017,17(5):57-58.DOI:10.13638/j.issn.1671-4040.2017.05.035.
[15]陈培栋,房利勤.红花注射液和注射用红花黄色素药理作用研究[J].世界中医药,2016,11(2):308-310.
[16]杨晓媛,任玉芳.红花黄色素药理作用研究进展[J].热带医学杂志,2015,15(3):421-424.
[17]严思,符之月,李翠,颜光寰,蒙绪君.无创正压通气辅助纳洛酮联合红花黄色素治疗重症肺心病合并呼吸衰竭的疗效观察[J].疑难病杂志,2017,16(7):678-681.DOI:10.3969/j.issn.1671-6450.2017.07.008.
[18]孙薇,王海燕,文仲光,等.肺癌并发肺栓塞患者的临床特征[J].中华结核和呼吸杂志,2016,39(3):198-202.DOI:10.3760/cma.j.issn.1001-0939.2016.03.012.
[19]常智.23例肺癌合并肺栓塞的回顾性分析[J].贵阳中医学院学报,2012,34(4):27-29.DOI:10.3969/j.issn.1002-1108.2012.04.014.
[20]黎金玲,胡敏,孙春燕,等.肺癌合并肺栓塞患者溶栓抗凝的观察与护理[J].上海护理,2013,13(4):39-41.DOI:10.3969/j.issn.1009-8399.2013.04.012.
[2]BECATTINI C,COHEN A T,AGNELLI G,et al.Risk Stratification of Patients With Acute Symptomatic Pulmonary Embolism Based on Presence or Absence of Lower Extremity DVT:Systematic Review and Meta-analysis[J].Chest,2016,149(1):192-200.DOI:10.1378/chest.15-0808.
[3]王峻,周卫华,许林,等.肺癌合并肺栓塞危险因素及预后的临床分析[J].中国肺癌杂志,2011,14(10):780-784.DOI:10.3779/j.issn.1009-3419.2011.10.03.
[4]TANABE Y,OBAYASHI T,YAMAMOTO T,et al.Predictive value of biomarkers for the prognosis of acute pulmonary embolism in Japanese patients:Results of the Tokyo CCU Network registry[J].J Cardiol,2015,66(6):460-465.DOI:10.1016/j.jjcc.2015.03.002.
[5]MEINEL F G,NANCE J W Jr,SCHOEPF U J,et al.Predictive Value of Computed Tomography in Acute Pulmonary Embolism:Systematic Review and Meta-analysis[J].Am J Med,2015,128(7):747-759.DOI:10.1016/j.amjmed.2015.01.023.
[6]中国抗癌协会肺癌专业委员会.2010中国肺癌临床指南[M].北京:人民卫生出版社,2010:31.
[7]中华医学会呼吸病学分会.肺血栓栓塞症的诊断与治疗指南(草案)[J].中华结核和呼吸杂志,2001,24(5):259-264.
[8]PIAZZA G,HOHLFELDER B,JAFF M R,et al.A Prospective,Single-Arm,Multicenter Trial of Ultrasound-Facilitated,CatheterDirected,Low-Dose Fibrinolysis for Acute Massive and Submassive Pulmonary Embolism:The SEATTLEⅡStudy[J].JACC Cardiovasc Interv,2015,8(10):1382-1392.DOI:10.1016/j.jcin.2015.04.020.
[9]李娜,王燕.23例肺癌并发肺栓塞的临床分析[J].中国肺癌杂志,2014,17(3):254-259.DOI:10.3779/j.issn.1009-3419.2014.03.12.
[10]石宗华,师广勇,孙哲,等.肺癌合并肺栓塞危险因素的病例对照研究[J].中华肿瘤防治杂志,2015,22(11):863-866.DOI:10.16073/j.cnki.cjcpt.2015.11.011
[11]田学涛,黄吉利.肺癌患者肺栓塞的危险因素研究[J].实用心脑肺血管病杂志,2017,25(2):50-52.DOI:10.3969/j.issn.1008-5971.2017.02.013.
[12]吴升,杨丽华,梁梅恨.50例肺癌合并肺栓塞的临床诊治分析[J].临床肺科杂志,2016,21(2):335-337.DOI:10.3969/j.issn.1009-6663.2016.02.041.
[13]HU H M,CHEN L,FRARY C E,et al.The beneficial effect of batroxobin on blood loss reduction in spinal fusion surgery:a prospective,randomized,double-blind,placebo-controlled study[J].Arch Orthop Trauma Surg,2015,135(4):491-497.DOI:10.1007/s00402-015-2183-0.
[14]王峰.中西医结合治疗肺栓塞疗效分析[J].实用中西医结合临床,2017,17(5):57-58.DOI:10.13638/j.issn.1671-4040.2017.05.035.
[15]陈培栋,房利勤.红花注射液和注射用红花黄色素药理作用研究[J].世界中医药,2016,11(2):308-310.
[16]杨晓媛,任玉芳.红花黄色素药理作用研究进展[J].热带医学杂志,2015,15(3):421-424.
[17]严思,符之月,李翠,颜光寰,蒙绪君.无创正压通气辅助纳洛酮联合红花黄色素治疗重症肺心病合并呼吸衰竭的疗效观察[J].疑难病杂志,2017,16(7):678-681.DOI:10.3969/j.issn.1671-6450.2017.07.008.
[18]孙薇,王海燕,文仲光,等.肺癌并发肺栓塞患者的临床特征[J].中华结核和呼吸杂志,2016,39(3):198-202.DOI:10.3760/cma.j.issn.1001-0939.2016.03.012.
[19]常智.23例肺癌合并肺栓塞的回顾性分析[J].贵阳中医学院学报,2012,34(4):27-29.DOI:10.3969/j.issn.1002-1108.2012.04.014.
[20]黎金玲,胡敏,孙春燕,等.肺癌合并肺栓塞患者溶栓抗凝的观察与护理[J].上海护理,2013,13(4):39-41.DOI:10.3969/j.issn.1009-8399.2013.04.012.