血小板对胃癌患者化疗效果的影响

Effect of platelets on chemotherapy in patients with gastric carcinoma

摘要:

目的 探讨血小板对胃癌患者化疗效果的影响。方法 选取2014 年2 月-2015 年7 月齐齐哈尔医 学院附属第三医院接受化疗的胃癌患者114 例，依据血小板计数分为≤ 300×109 个/L 组与>300×109 个/L 组，比较两组临床疗效、清蛋白、前清蛋白、肿瘤坏死因子α、白细胞介素6、C 反应蛋白水平。结果 ≤ 300×10 个9/L 组与>300×109 个/L 组患者的有效率比较，经χ2 检验，差异有统计学意义（P <0.05），≤ 300×109 个/L 组高于>300×109 个/L 组。化疗前，两组患者的清蛋白、前清蛋白差异无统计学意义（P >0.05）。 化疗后，≤ 300×109 个/L 组与>300×109 个/L 组患者的清蛋白、前清蛋白比较，经t 检验，差异有统计学意 义（P <0.05），≤ 300×109 个/L 组高于>300×109 个/L 组。化疗前，两组患者的肿瘤坏死因子α、白细胞 介素6、C 反应蛋白差异无统计学意义（P >0.05）。化疗后，≤ 300×109 个/L 组与>300×109 个/L 组患者的 肿瘤坏死因子α、白细胞介素6、C 反应蛋白比较，经t 检验，差异均有统计学意义（P <0.05），≤ 300×109 个/L 组低于>300×109 个/L 组。结论 血小板异常升高的胃癌患者化疗效果普遍不佳，可能存在营养不良、 免疫功能紊乱等问题，临床上应对胃癌患者的血小板水平进行密切监测和有效干预。

Abstract:

Objective To study the effect of platelets on chemotherapy in patients with gastric cancer. Methods Totally 114 patients with gastric cancer who received chemotherapy in our hospital from February 2014 to July 2015 were selected. According to platelet count they were divided into ≤ 300×109 /L group and >300×109 /L group. Clinical efficacy, serum albumin, prealbumin, tumor necrosis factor alpha, interleukin 6, and C-reactive protein were compared between the two groups. Results The effective rate of the ≤ 300×109 /L group was significantly higher than that of the > 300×109 /L group (P < 0.05). Before chemotherapy, there was no significant difference in albumin or prealbumin between the two groups (P > 0.05); after chemotherapy, the levels of albumin and prealbumin of the ≤ 300×109 /L group were significantly higher than that of the >300×109 /L group. Before chemotherapy, there was no significant difference in tumor necrosis factor alpha, interleukin 6 or C-reactive protein between the two groups (P > 0.05); after chemotherapy, the levels of tumor necrosis factor alpha, interleukin 6 and C-reactive protein in the ≤ 300×109 /L group were obviously lower than those in the >300×109 /L group. Conclusions The chemotherapy effect of the gastric cancer patients with abnormal platelet elevation is generally poor, there may be malnutrition, immune dysfunction and other issues. In clinic the platelet levels in the patients with gastric cancer should be closely monitored and effectively intervened.