沙利度胺对放射性肺损伤影响的实验研究  

Experimental study of the effects of thalidomide on radiation- induced pulmonary injury

作　　者：尹卫华[1] 聂春华[1] 夏红梅[2] 钱小军[1] 曾佳[1] 徐荣[3] 江健[1] 余晚婷 

机构地区：[1]宜春市人民医院暨宜春学院临床医学院肿瘤科,江西宜春336000 [2]宜春市人民医院暨宜春学院临床医学院康复科,江西宜春336000 [3]宜春市人民医院暨宜春学院临床医学院检验科,江西宜春336000

出　　处：《现代肿瘤医学》2016年第19期3012-3016,共5页Journal of Modern Oncology

摘　　要：目的:研究沙利度胺对放射性肺损伤的影响并观察其量效关系。方法:以不同剂量沙利度胺对放疗(6MV-X线20Gy一次肺部照射)后的125只SD大鼠进行治疗,照射后第7、15、30、45、60d各组随机取5只大鼠处死,观察外周血白细胞(WBC)、IL-1、IL-4、IL-6和TNF-α水平的变化及组织的超氧化物歧化物(SOD)、丙二醛(MDA)、羟脯氨酸(HP)含量的改变。结果:单纯照光组外周血WBC、中性粒细胞(PMN)数、炎症因子IFN-γ、IL-6和TNF-α均呈明显上升,后期肺组织大量胶原纤维增生,SOD明显下降,MDA、HP明显上升;沙利度胺治疗组WBC、PMN细胞数、炎症因子IFN-γ、IL-6和TNF-α均呈上升趋势,但上升幅度小,后期肺组织沙利度胺小剂量组少量胶原纤维增生,沙利度胺大剂量、中剂量组未见胶原纤维增生。从30d、60d时间点比较,沙利度胺大、中剂量组在WBC、PMN、IFN-γ、IL-6、TNF-α、SOD、MDA、HP的改善与沙利度胺小剂量组、单纯照光组相比差异显著(P<0.05),但沙利度胺大、中剂量组之间无明显差异(P>0.05),沙利度胺大剂量组嗜睡时间长。结论:沙利度胺通过抗氧化、抑制炎症因子的机制,发挥抗炎和抗纤维化作用来减少放射性肺损伤。沙利度胺中剂量组毒副反应小,安全、有效、性价比最高。Objective：To study the effects of thalidomide on radiation induced lung injury and its dose-response relationships.Methods：All 125 SD rats were exposed to 6 MV X-ray at a dose of 20Gy then treated with different doses of thalidomide.5 rats were selected randomly in each group after 7d,15d,30d,45d,60d of radiation.Observed the change of WBC in peripheral blood at time points,detected the serum IL-4,IL-6 and TNF-αlevel of rats,and investigated the change of content of SOD,MDA and HP in lung tissue.Results：WBC,PMN,serum IFN-γ,IL-6 and TNF-αlevel in peripheral blood of the radiation exposure group increased significantly,more collagen prolifera-tion in lung tissue at late stage,SOD content decreased significantly ,MPA and HP content increased significantly.WBC,PMN,serum IFN -γ,IL -6 and TNF -αlevel in peripheral blood of the thalidomide treatment group in-creased,the increase was slight,small amounts of collagen proliferation in the thalidomide low dose group at late stage.No collagen proliferation in the thalidomide high dose group and the thalidomide middle dose group.At the 30d and 60d,the level of WBC,PMN,serum IFN-γ,IL-6 and TNF-αin the thalidomide high dose group and the tha-lidomide middle dose group increased significantly compared with the other two groups（P〈0.05）,there was no sig-nificant difference between high and middle dose groups（P〉0.05）.The drowsiness time of the thalidomide high dose group was longer than the other three groups.Conclusion：Thalidomide plays the role of anti-inflammatory and anti fibrosis by inhibition of inflammatory cytokines to relieve radiation lung injury,which is safe and effective and are ac-cepted by patients.

关 键 词：沙利度胺 放射性肺损伤 量效关系 

分 类 号：R730.55[医药卫生—肿瘤]