摘要目的:评价阿帕替尼治疗晚期肺癌的疗效。方法:抽取商丘第一人民医院2018年2月至2020年1月收治的的Ⅳ期肺癌患者164例，按随机数字表法分为阿帕替尼组(82例)与对照组(82例)。对照组应用紫杉醇单药治疗，剂量75 mg/m 2。阿帕替尼组给予甲磺酸阿帕替尼片口服，425 mg/次，3次/d，治疗3周后重复1次。治疗前后比较两组胞角蛋白19片段、癌胚抗原。比较两组患者疗效、无进展生存期及不良反应发病率。采用Cox风险比例模型评价患者预后的相关因素。 结果:治疗后，阿帕替尼组癌胚抗原、胎教蛋白19片段低于对照组( P<0.001)；与对照组比较，阿帕替尼组有效率显著提高[76.9%(63/82)比58.5%(48/82)， χ2＝6.27， P＝0.012]，不良反应发病率显著降低[25.6%(21/82)比45.1%(37/82)， χ2＝6.83， P＝0.009]。阿帕替尼组无进展生存期(4.3个月)少于对照组(3.2个月)， P<0.05。阿帕替尼治疗晚期肺癌的独立相关因素有美国东部肿瘤协作组体能状态评分、组织分化程度、解剖学位置、不良反应与化疗。 结论:晚期肺癌患者应用阿帕替尼治疗疗效高，耐受性好，不良反应少，值得临床推广。

abstractsObjective:To evaluate the clinical efficacy of apatinib in the treatment of advanced lung cancer.Methods:A total of 164 patients with stage IV lung cancer who were treated in Shangqiu First People’s Hospital from February 2018 to January 2020 were enrolled in the study. The patients were divided into apatinib group ( n=82) and control group ( n=82) by random number table method. The control group was treated with paclitaxel as a single agent at a dose of 75 mg/m 2, while the apatinib group was treated with apatinib mesylate tablets orally, 425 mg/time, 3 times/d, and repeated once after 3 weeks of treatment. The serum cytokeratin 19 fragment and carcinoembryonic antigen were compared between the two groups before and after treatment. The efficacy, progression-free survival and incidence of adverse reactions were compared between the two groups. The Cox risk ratio model was used to evaluate the factors related to the prognosis of patients. Results:After treatment, carcinoembryonic antigen and cytokeratin 19 fragment in the apatinib group were significantly lower than those in the control group ( P<0.001). The effective rate of the apatinib group (76.9%, 63/82) was higher than that of the control group (58.5%, 48/82), and the difference was significant ( χ2=6.27, P=0.012). The incidence of adverse reactions in the apatinib group was 25.6% (21/82), lower than the 45.1% (37/82) in the control group ( χ2=6.83, P<0.05). The progression-free survival time (4.3 months) of the apatinib group was less than that of the control group (3.2 months), P<0.05. Independently related factors for apatinib in the treatment of advanced lung cancer included the performance status score of the Eastern Cooperative Oncology Group, the degree of tissue differentiation, anatomical location, adverse reactions and chemotherapy. Conclusions:The application of apatinib to patients with advanced lung cancer has high efficacy, good tolerability and few adverse reactions.