混合糖电解质注射液辅助治疗晚期非小细胞肺癌的疗效及对免疫的影响  

Clinical efficacy and immunomodulatory effect of carbohydrate and electrolyte injection on advanced non-small cell lung cancer patients

作　　者：于洋[1] 刘武 周炜 刘勇[1] 李擎[1] 王水英[1] 王燕[1] 王群[1] 程隆 YU Yang;LIU Wu;ZHOU Wei;LIU Yong;LI Qing;WANG Shuiying;WANG Yan;WANG Qun;CHENG Long(Dept. of Medical Oncology,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China;Dept. of Invasive Technology,Xuzhou Central Hospital,Xuzhou 221009,Jiangsu,China;Dept. of Internal Medicine,Hunan Cancer Hospital,Changsha 410013,Hunan,China;Dept. of Medical Oncology,Suixi County Hospital of Traditional Chinese Medicine,Huaibei 235100,Anhui,China)

机构地区：[1]徐州市中心医院肿瘤内科,江苏徐州221009 [2]徐州市中心医院介入科,江苏徐州221009 [3]湖南省肿瘤医院内科,湖南长沙410013 [4]濉溪县中医院肿瘤内科,安徽淮北235100

出　　处：《武汉大学学报（医学版）》2019年第1期61-65,共5页Medical Journal of Wuhan University

基　　金：徐州市科技项目(KC16SH096);徐州市科技情报研究计划项目(XKQ053);徐州市中心医院博士创新团队科技项目(XZB201618)

摘　　要：目的:探讨晚期非小细胞肺癌患者在化疗过程中辅助应用混合糖电解质注射液的临床疗效和对免疫功能的影响。方法:选择2016年1月-2017年6月在徐州市中心医院肿瘤中心治疗的82例晚期非小细胞肺癌患者,随机分为观察组41例和对照组41例,对照组在GP方案化疗同时联合葡萄糖注射液,观察组在GP方案化疗同时应用混合糖电解质注射液。比较两组患者治疗后的疗效、毒副反应及免疫功能。结果:2周期化疗后,观察组治疗的有效率(CR+PR+SD)为68.3%,对照组63.4%,两组的疗效无统计学差异(P>0.05);毒副反应方面,恶心呕吐、血小板下降、白细胞下降和肝功能损伤等两组无显著差异(P>0.05),但观察组的肾功能损伤和口腔黏膜炎明显少于对照组(P<0.05);免疫功能方面,观察组CD4+T、CD4+T/CD8+T和NK细胞均较治疗前有所升高(P<0.05),且和对照组相比,CD4+T、CD4+T/CD8+T和NK细胞亦有明显升高(P<0.05)。同时,和对照组相比,观察组白细胞介素(IL)-1β、IL-4、IL-6、肿瘤坏死因子-α(TNF-α)均显著降低(P<0.05),IL-2和干扰素-γ(IFN-γ)均显著增高(P<0.05)。结论:与葡萄糖注射液比,混合糖电解质注射液辅助化疗治疗晚期非小细胞肺癌,在同等疗效的情况下能有效减轻肾功能损害和口腔黏膜炎,并显著提高患者免疫状况。Objective: To investigate the clinical efficacy and immunomodulatory effect of carbohydrate and electrolyte injection on advanced non-small cell lung cancer patients. Methods: A total of 82 adancednon-small cell lung cancer patients were selected from oncology center of Xuzhou Central Hospital from January 2016 to June 2017, and were randomly divided into control group(n=41) and carbohydrate and electrolyte group(n=41), which were treated with GP chemotherapeutic regimen plus 5%glucose injection and with GP plus carbohydrate and electrolyte injection, respectively. After 2 cycles of treatment, the clinical effect, adverse reactions, the peripheral blood T cell subsets, and inflammatory factors between the two groups were compared. Results: After 2 cycles of chemotherapy, no significant difference was found in the total efficiency(CR+PR+SD) and side-effects incidence between the two groups(P>0.05), except that carbohydrate and electrolyte group showed less kidney dysfunction and oral mucosal inflammation cases(P<0.05). For the immune function, after treatment, the CD4+ T, CD4+ T/CD8+ T,and NK cells levels were higher in carbohydrate and electrolyte group than those in the control group(all P<0.05). Besides, compared with those in control group, the serum levels of interleukin-1 beta(IL-1β), interleukin-4(IL-4), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) were lower(P<0.05),and interleukin-2(IL-2) and interferon-γ(IFN-γ) levels were higher(P<0.05) in the carbohydrate and electrolyte group. Conclusion: The carbohydrate and electrolyte injection is more effective rather than 5% glucose injection, combined with GP chemotherapeutic regimen,to treat advanced non-small cell lung cancer, and it can reduce the renal dysfunction and strengthen the immune system against cancer.

关 键 词：非小细胞肺癌 化疗 混合糖电解质注射液 临床疗效 毒副反应 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]