脾多肽对晚期卵巢癌化疗引起骨髓抑制影响  

Effect of spleen polypeptide on bone marrow suppression induced by chemotherapy in advanced ovarian cancer

作　　者：代平 王于理[1] 王金辉 林芷伊[1] 张珂 徐丹 巩平[1] DAI Ping;WANG Yu-li;WANG Jin-hui;LIN Zhi-yi;ZHANG Ke;XU Dan;GONG Ping(Department of Oncology ,First Affiliated Hospital of Medical College of Shihezi University, Shihezi 832000, P. R. China;School of Pharmacy, Shihezi University ,Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi 832002, P. R. China;School of Pharmacy, Harbin Medical University, Harbin 150081 ,P. R. China)

机构地区：[1]石河子大学医学院第一附属医院肿瘤内科,新疆石河子832000 [2]石河子大学药学院.新疆植物药资源利用教育部重点实验室,新疆石河子832000 [3]哈尔滨医科大学药学院,黑龙江哈尔滨150081

出　　处：《中华肿瘤防治杂志》2018年第6期437-441,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：石河子大学医学院第一附属医院横向课题

摘　　要：目的卵巢癌是常见的妇科恶性肿瘤之一,有研究表明脾多肽注射液在不同癌种化疗中具有提高免疫、改善骨髓抑制的作用。本研究通过自身对照试验,探讨脾多肽注射液对晚期卵巢癌化疗引起骨髓抑制的影响,以期为该药的临床应用提供证据。方法纳入石河子大学医学院第一附属医院肿瘤科2016-11-01-2017-07-01收治住院化疗的晚期卵巢癌患者60例,前后自身对照,治疗3个周期。第1个周期单纯紫杉醇联合卡铂(TC方案)化疗,第2、3个周期脾多肽联合TC方案化疗,比较各周期治疗后骨髓抑制发生情况,进一步比较各周期治疗前后白细胞计数(white blood cell,WBC)、中性粒细胞计数(neutrophil,N)、血小板计数(blood platelet,PLT)、红细胞计数(red blood cell,RBC)、血红蛋白(hemoglobin,Hb)、天冬氨酸转氨酶(aspartate amino transferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、肌酐(creatinina,Cr)和血尿素氮(blood urea nitrogen,BUN)均值变化。结果第2、3个周期骨髓抑制发生率明显低于第1个周期,差异有统计学意义,Pearsonχ2值分别为63.052和83.426,均P<0.001;第2个与第3个周期比较,差异无统计学意义,Pearsonχ2=3.064,P=0.132。第1个周期治疗前后上述实验室检查各指标差异均有统计学意义(P<0.05),提示发生明显骨髓抑制;第2个周期加用脾多肽后,除N、RBC、Hb和Cr改善不明显,其余指标均改善明显,差异均有统计学意义,P<0.05;第3个周期治疗前后各项实验室指标变化差异均无统计学意义(P>0.05),提示未发生明显的骨髓抑制。结论联合应用脾多肽可改善晚期卵巢癌TC方案化疗引起的骨髓抑制,多周期持续联合应用脾多肽可能达到叠加改善化疗引起骨髓抑制的作用。OBJECTIVE Ovarian cancer is one of the common gynecological malignancies.Some studies have shown that spleen polypeptide injection has the effect of enhancing immunity and improving bone marrow suppression in chemotherapy of different cancers.This study was based on the self-controlled study to explore the effect of spleen polypeptide on the bone marrow suppression caused by chemotherapy in advanced ovarian cancer,and to provide evidences for clinical drug use.METHODS Sixty patients with advanced ovarian cancer in the Department of Oncology of the First Affiliated Hospital of Shihezi University were selected as samples in this study from November 1 st,2016 to July 1 st,2017,with the application of self control before-after trail method and three treatment cycles,including the first cycle of solely TC chemotherapy alone,the second and the third cycle of spleen polypeptide combined with TC chemotherapy.The comparisons of the occurrence of bone marrow suppression after the treatment of each cycle were made and the changes of the mean value of WBC,N,PLT,RBC,Hb,AST,ALT,Cr and BUN were further analyzed.RESULTS The incidence of bone marrow suppression is significantly lower in the second and third cycles than that in the first treatment cycle,with a difference of statistical significance（Pearsonχ2=63.052,P〈0.001）,（Pearsonχ2=83.426,P〈0.001）,but the difference between the second and third cycle is of no statistical significance（Pearsonχ2=3.064,P=0.132）.The differences of the observed indexes before and after treatment in the first cycle are statistically significant（P〈0.05）,which indicates that obvious bone marrow suppress has occurred.After the addition of spleen polypeptide in the second cycle,the improvements of all the indexes are obviously,except N,RBC,Hb and Cr（P〈0.05）.In the third treatment cycle,the differences were not statistically significant（P〈0.05）,indicating that there is no obvious bone marrow suppression.CONCLUSIONS Combined application of spleen polypeptide can improve

关 键 词：脾多肽 卵巢癌 骨髓抑制 自身对照试验 

分 类 号：R737.31[医药卫生—肿瘤]