急性放疗致口腔炎患者唾液和外周血炎症细胞因子的变化及意义  

The Changes and Clinical Significance of Inflammatory Cytokines in Saliva and Peripheral Blood of Patients with Acute Radiation-Induced Stomatitis

作　　者：沈红梅[1] 黄杰[1] 金从国[1] 杨毅[1] 段林灿[1] 赵瑞莲[1] 

机构地区：[1]昆明医学院第三附属医院,云南省肿瘤研究所中西医结合肿瘤临床研究中心,650118

出　　处：《天津医药》2012年第11期1103-1106,共4页Tianjin Medical Journal

基　　金：云南省自然科学基金项目(项目编号:2009CD182);云南省卫生厅科技计划项目(项目编号:2010NS086);云南省教育厅科学研究基金项目(项目编号:2010Y186)

摘　　要：目的:探讨行根治性放疗的鼻咽癌患者急性放射性口腔炎发生发展过程中唾液和外周血中炎症细胞因子变化及其临床意义。方法:选取拟行根治性放疗的鼻咽癌患者40例,于放疗剂量(DT)为0、40、70Gy时,检测其唾液和外周血中干扰素(IFN)-γ、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-2、IL-4、IL-6、IL-106种炎症细胞因子水平。结果:(1)在DT为0、40、70Gy时,唾液中IFN-γ、TNF-α、IL-2、IL-4、IL-6、IL-10的水平均明显高于血液,差异有统计学意义(P<0.01)。(2)唾液和血液中的IFN-γ、TNF-α、IL-2、IL-4、IL-6、IL-10在放疗剂量达40Gy时均较放疗前明显升高(P<0.01)。(3)放疗剂量达70Gy时唾液和血液除IL-10继续明显升高外(P<0.01),IFN-γ、TNF-α、IL-2、IL-6均显著低于放疗前(P<0.01),唾液IL-4水平明显低于放疗前(P<0.001),而血液IL-4水平与放疗前差异无统计学意义(P>0.05)。结论:炎症因子在鼻咽癌根治性放疗患者急性放射性口腔炎发生发展过程中起了重要作用,唾液和血液中炎症因子变化相似。Objective： To investigate the changes and clinical significance of inflammatory cytokines in saliva and peripheral blood of the patients with nasopharyngeal carcinoma undergoing radical radiotherapy. Methods： Forty patients with nasopharyngeal carcinoma, who underwent radical radiotherapy, were included in this study. The levels of interferon （IFN）-γ tumor necrosis factor （TNF）-α, interleukin （IL）-2, IL-4, IL-6 and IL-10 in saliva and peripheral blood were detected in patients with three doses of radiotherapy including DT=0 Gy, DT=40 Gy and DT= 70 Gy. Results： （1） The levels of six cytokines （IFN-γ, TNF-α, IL-2, IL-4, IL-6 and IL-10） were significantly higher in saliva than those in peripheral blood （P 〈 0.01） at three doses of radiotherapy. （2） The levels of six cytokines were significantly increased in both saliva and peripheral blood at DT=40 Gy compared with those at DT=0 Gy （P 〈 0.01）. （3） The level of IL-10 increased in saliva and peripheral blood at DT=70 Gy （P 〈 0.01）, whereas levels of IFN-γ, TNF-α, IL-2 and IL-6 decreased compared with those at DT=0 Gy （P 〈 0.01）. The level of IL-4 in saliva was lower at DT=70 Gy than that at DT-=0 Gy （P 〈 0.001）. There was no significant difference in the blood level of IL-4 between DT=70 Gy and DT=0 Gy （P 〉 0.05）. Conclusion： Inflammatory factors played an important role in the occurrence and development process of nasopharyngeal radical radiotherapy in patients with acute radiation stomatitis. Changes of cytokine similar to that of salivavy.

关 键 词：急性病 口腔疾病 口炎 放射疗法 炎症趋化因子类 唾液 血液 

分 类 号：R276.815[医药卫生—中医五官科学]