斑螯酸钠维生素B_6注射液联合化疗对肺癌组织FAS表达及细胞超微结构的影响研究  

Effect of sodium cantharidiniate and Vitamin B_6 injection combined chemotherapy on FAS expression and cell ultrastructure of lung cancer tissue

作　　者：蒋云[1] 李志强[2] 周丽芳[1] 毛晨梅[1] 魏继武[3] 

机构地区：[1]苏州大学附属儿童医院药剂科,江苏苏州215000 [2]东南大学医学院附属江阴医院药剂科,江苏江阴214400 [3]南京大学医学院附属鼓楼医院药剂科,南京210008

出　　处：《重庆医学》2016年第35期4922-4925,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81172143)

摘　　要：目的探讨斑螯酸钠维生素B_6注射液(商品名:艾易舒)联合化疗对非小细胞肺癌(NSCLC)患者癌变组织FAS蛋白表达及细胞超微结构的影响。方法选取84例NSCLC患者为研究对象,随机数字表法分为联合组和对照组,每组42例。对照组中途剥落2例,共40例有效病例入组,予以单纯吉西他滨+顺铂(GP)化疗方案;联合组剥落4例,共38例有效病例入组,予以艾易舒注射液联合GP化疗方案。对比两组受试者2个化疗周期后临床疗效及毒副反应发生率的差异,记录其治疗前后Karnofsky功能状态量表(KPS)评分、癌变组织FAS蛋白阳性表达水平变化情况,分析联合组治疗前后细胞超微结构变化差异。结果联合组治疗总有效率明显高于对照组(44.7%vs.22.5%,P<0.05)。治疗后,两组发热、神经反应降低、肾损伤等毒副反应发生率比较差异无统计学意义(P>0.05),联合组骨髓抑制、恶心呕吐中重度毒副反应发生率明显低于对照组(P<0.05)。治疗后,两组受试者KPS评分及癌变组织FAS蛋白阳性表达率均较治疗前明显提升,且联合组高于对照组(P<0.05)。联合组受试者癌细胞的超微结构均出现不同程度的改变,部分可见癌细胞细胞质萎缩、染色质破裂、细胞器退变或凋亡;多数存在膜性结构裂隙、内质网结构松散或脱颗粒等变化。结论艾易舒注射液联合GP化疗方案对促进NSCLC患者病情转归、改变癌细胞超微结构、减轻毒副作用等具有积极意义。Objective To investigate the effect of sodium cantharidiniate and Vitamin B6 injection combined chemotherapy on FAS expression and cell ultrastructure in patients with non-small-cell lung carcinorna（NSCLC）. Methods Eight-four patients with NSCLC were selected as the study subjects. By the random number table method, they were divided into the combination group and the control group,42 cases in each group. There were 2 cases lost to follow up and 40 effective cases were included in the control group,they were treated with simple GP chemotheraPy（gemcitabine-/cisplatin）. There were 4 cases lost to follow up and 38 effective cases were enrolled in the combination group,they were treated with sodium cantharidiniate and vitamin B6 injection combined with GP chemotherapy. The clinical curative effect and incidence of side effects were compared between the two groups after 2 cycles of chemotherapy. The changes of Karnofsky performance scale（KPS） score and positive expression of FAS in cancerous tissues were recorded before and after treatment. The changes of cell ultrastructure in the combination group before and after treatment were analyzed. Results The total response rate in combination group was significantly higher than that in control group（44.7% vs. 22.5%, P〈0.05）. After treatment, there was no significant difference in the incidence of side effects such as fever, declined neural response and renal function damage between the two groups（P〉0.05）. The incidence rates of myelosuppression,nausea and vomiting and other moderate to severe side effects in combination group were significantly lower than those in control group（P〈0.05）. After treatment,the KPS scores and positive expression rates of FAS in the cancerous tissues of both groups were significantly higher than those before treatment, and those in combined group were higher than those in control group（P〈0.05）. The ultrastructure of cancer cells in combination group showed varying degrees of change. Some showed cancer cell cyto

关 键 词：斑螯酸钠维生素B6注射液 化学治疗 癌 非小细胞肺 FAS蛋白 超微结构 

分 类 号：R734.2[医药卫生—肿瘤]