胸腺肽α1降低老年肺癌患者化疗期间感染风险及对预后的影响  

Research on the Significance of Thymosin Α1 for Infection Risk and Prognosis in Elderly Lung Cancer Patients Received Chemotherapy

作　　者：乔丹[1] 王智煜[1] 文孝婷 陆耀红[1] 赵晖[1] 

机构地区：[1]上海交通大学附属第六人民医院,上海200233

出　　处：《中国肿瘤》2015年第8期696-701,共6页China Cancer

基　　金：国家自然科学基金(81201628)

摘　　要：[目的]探讨胸腺肽α1对降低老年肺癌患者化疗期间感染风险的作用及对预后的影响。[方法]选取年龄〉60岁、接受含铂一线化疗的老年肺癌患者198例,根据治疗方式分为实验组与对照组,实验组在化疗期间同时联合胸腺肽α1免疫支持治疗,比较两组患者化疗期间细胞免疫功能、感染率及生存率。[结果]治疗后实验组血清CD3^＋、CD4^＋和NK细胞明显升高,CD8^＋细胞明显下降,较治疗前水平及对照组均有统计学差异（P〈0.05）;化疗期间实验组感染率明显低于对照组（P〈0.05）。多因素分析结果显示胸腺肽α1免疫支持治疗是感染的保护性因素（OR=0.45,95%CI：0.23～0.89,P=0.021）。实验组与对照组中位生存时间分别为14.36个月和13.06个月,组间无统计学差异（P〉0.05）;实验组中感染患者预后明显优于对照组（P〈0.05）。[结论 ]胸腺肽α1能有效降低老年肺癌患者化疗期间感染率及感染相关死亡率。[Purpose] To evaluate significance of thymosin α1（Tα1） for infection risk and prognosis in elderly lung cancer patients received chemotherapy. [Methods] A total of 198 cases with lung cancer over 60-years-old received platinum-based chemotherapy were classified into the control group（n =112） and the observation group with additional thymosin α1（n =86） according to treatment schemes. Changes in cellular immunology function,infection rates and overall survival rates were compared between the two groups. [Results] After treatment,the levels of serum CD3^＋,CD4^＋and NK significantly increased,CD8^＋significantly decreased in the observation group comparing with the control group and the pretreatment levels（P〈0.05）. The infection rates of observation group were far lower than the control group（P〈0.05）. Multivariate Logistic regression analysis showed thymosin α1 was protective factor（OR=0.45,95%CI：0.23～0.89,P=0.021）. The median survival time between observation group and control group had no statistical difference（14.36 months vs 13.06 months,P〉0.05）. Patients with infection in observation group had a better prognosis than those in control group（P〈0.05）. [Conclusion] Thymosin α1 can effectively decrease the infection rates and infection-related death rates of elderly lung cancer patients who received platinum-based chemotherapy.

关 键 词：老年 肺癌 感染 预后 胸腺肽Α1 

分 类 号：R734.2[医药卫生—肿瘤]