电离辐射导致机体应激反应的临床研究  

Clinical study on ionizing radiation-induced stress response in vivo

作　　者：王晓萍[1] 丁巍[1] 张道富[1] 傅辰春[1] 张新良[1] 周彬[1] 

机构地区：[1]解放军八一医院全军肿瘤中心放疗科

出　　处：《临床肿瘤学杂志》2008年第7期607-610,共4页Chinese Clinical Oncology

摘　　要：目的:探讨电离辐射在作为常规放射治疗手段时,对机体内环境稳定性的可能影响和程度。方法:选择经病理确诊、具有放疗适应证、卡氏评分≥70分的不同部位的恶性肿瘤患者50例,予1次/天,2Gy/次的X线照射。照射中位体积为488.8cm3。分别在3个观察时间点(放疗前1天和放疗后第1、2天)进行临床症状观察和部分应激反应指标的检测。采用配对t检验分析照射前后各观察指标的差异。采用Pearson相关系数分析照射体积和各观察指标的关系。结果:临床症状在3个观察时间点未发现治疗相关毒副反应。指标检测中WBC在放疗后第1天较放疗前增高,IL-6在放疗后第2天较第1天增高,差异均有统计学意义(P<0.05)。ESR和CRP在各时间点未观察到明显差异。放疗后第2天与放疗前,不同照射体积的WBC差值有统计学意义(P<0.05);放疗前,放疗后第1天和第2天,不同照射体积的IL-6差值有统计学意义(P<0.05)。WBC在放疗后第2天与放疗前的差值与照射体积的相关性有显著的统计学意义(相关系数r=0.495,P=0.001)。结论:(1)电离辐射在治疗初期对机体内环境具有一定影响。(2)此类应激反应程度轻,对生理功能干扰小。(3)研究显示了放射治疗安全、无创的应用优势。应激反应与观测时间点、照射体积及旁效应的关系尚需进一步研究。Objective ：To evaluate the potential effects and degrees on the stability of the inner environment induced by ionizing radiation as the regular radiotherapy. Methods：Clinical symptoms and some tests on stress response were analyzed in fifty cancer patients treated by radiotherapy at three time-points （ 1 day before radiation, 1 and 2 days after radiation ） respectively. All the cases meet the following conditions; cytohistologic diagnoses, indication for radiotherapy and karnofsky ≥70. The irradiation were delivered with X-ray by 1 F/day and 2Gy/fraction. The median-volume of iradiation is 488. 8cm3. The diferrence of detection indexes before and after irradiation was analyzed with t test. Pearson correlation coefficient was performed to analyze the correlation between the irradiation volum and detection index. Results ： Clinical symptoms ： no treatment related side-effects were observed. Tests ： WBC is higher on the first day after radiation than before radiation and IL-6 was higher on the second day after radiation than on the first day （ P 〈 0. 05 ）. No obvious difference was observed in ESR and CRP at all time-points. Irradiation volume： there are obvious significance for the difference values between two volum groups （ P 〈 0. 05 ） respectively on the first day after radiation and before radiation in WBC and on the first, the second day after radiation and before radiation in IL-6. The relationship between the difference value and irradiation volume is close on the second day after radiation and before radiation in WBC （r = 0. 495 ,P = 0. 001 ）. Conclusion：Some effects of the inner environment induced by ionizing radiation have been observed at the initial stage of irradiation. The degree of the stress response is trivial and the physiology function is slightly disturbed. The study shows that the radiotherapy is safe and hurtless. The relationships between stress response and observing time-points, irradiation volume and bystander effect would be further investigated.

关 键 词：电离辐射 应激反应 临床研究 

分 类 号：R730.55[医药卫生—肿瘤]