乌司他丁防治非小细胞肺癌患者放疗后放射性肺损伤的研究  

Protective effect of ulinastatin on lung injury in patients with non-small cell lung cancer after radiation therapy

作　　者：保鹏涛[1] 赵卫国[1] 李芸[1] 刘宇[1] 周怡[1] 汤丽萍[1] 

机构地区：[1]中国人民解放军第309医院呼吸科,北京100091

出　　处：《中国新药杂志》2014年第17期2066-2070,共5页Chinese Journal of New Drugs

摘　　要：目的:观察乌司他丁对非小细胞肺癌患者放疗后放射性肺损伤的防治作用。方法:120例非小细胞肺癌患者随机双盲分入试验组和对照组,试验组在放疗开始前3 d及放疗中前7 d接受乌司他丁治疗,同时对照组患者使用安慰剂治疗。在放疗开始前,放疗后第4,8,16,24周时检测患者血清中TGF-β1,IL-6和TNF-α水平。观察放疗后放射性肺损伤发生率及程度。患者在放疗开始前,放疗后第8,24周时行肺功能评估。结果:放疗后试验组患者血清中TGF-β1,IL-6和TNF-α水平明显低于对照组,特别是在前4周。放疗后试验组患者放射性损伤发生率及程度以及FEV1,DLCO和FVC等指标下降程度明显低于对照组,第8周时试验组FVC值明显低于对照组,在24周时FEV1,DLCO和FVC下降程度明显低于对照组。试验组患者生存周期及放疗效果无明显差异。结论:乌司他丁能有效降低非小细胞肺癌患者放疗后血清中TGF-β1,IL-6和TNF-α水平。而且能有效降低非小细胞肺癌患者放疗后放射性肺损伤发生率并减轻肺功能下降程度。Objective： To investigate the protective effect of ulinastatin on radiation-induced lung injury （RILI） in patients with non-small cell lung cancer （NSCLC） after radiation therapy. Methods： Totally 120 pa- tients with NSCLC were divided into two randomised and double-blind groups. Patients were treated either with uli- nastatin for 3 days prior to and for the first 7 days of radiotherapy, or with placebo for 10 days （control）. TGF-β1, IL-6 and TNF-α levels were measured at 4, 8, 16 and 24 weeks, and pulmonary function was evaluated at 8 and 24 weeks after radiation therapy commenced. Results： Fifty-seven patients in ulinastatin group and 55 patients in con- trol group completed the study. No toxicological effects of ulinastatin were observed. The incidence and grade of RILl were significantly lower in ulinastatin group than in control group at 8 and 24 weeks. Expression of TGF-β1, TNF-α and IL-6 in ulinastatin group significantly decreased compared to control group, especially in the first 4 weeks after beginning radiation therapy. FVC reduction at week 8, and FEV1, DLCO and FVC reductions at week 24 were significantly smaller in ulinastatin group than in the control group. No difference in survival or tumour re- sponse rate was found between the two groups. Conclusion： Ulinastatin effectively reduces the incidence and grade of RILI, decreases the TGF-β1, 1L-6 and TNF-α levels, and improves pulmonary function in NSCLC patients trea- ted with radiotherapy.

关 键 词：乌司他丁 放射性肺损伤 非小细胞肺癌 肺功能 细胞因子 

分 类 号：R979.9[医药卫生—药品]