解剖性肺切除术联合鸦胆子油乳与顺铂行胸腔内灌注对肺腺癌患者免疫功能及近远期疗效的影响  

Effect of intrapleural perfusion in patients with lung adenocarcinoma on the immune function and the short and long term efficacy of dissecting lung segment resection combined with crow’s bile oil emulsion and cisplatin

作　　者：罗洞波[1] 刘翼 初建虎[1] 汪洋[1] 吴振华[1] 何丹[1] LUO Dong-bo;LIU Yi;CHU Jian-hu(Department of Thoracic Surgery, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi Xinjiang 830011, China;Department of Thoracic Surgery, Shenzhen University General Hospital, Shenzhen Guangdong 518055, China)

机构地区：[1]新疆医科大学附属肿瘤医院胸外科,新疆乌鲁木齐830011 [2]深圳大学总医院胸外科,广东深圳518055

出　　处：《临床和实验医学杂志》2019年第12期1290-1293,共4页Journal of Clinical and Experimental Medicine

基　　金：新疆自治区自然科学基金(编号:2016D01C368)

摘　　要：目的探究与分析解剖性肺切除术联合鸦胆子油乳与顺铂行胸腔内灌注对肺腺癌患者免疫功能及近远期疗效的影响。方法回顾性分析2015年3月至2017年3月新疆医科大学附属肿瘤医院收治的68例接受解剖性肺切除术的肺腺癌患者的临床资料,根据治疗方法将患者分为两组,每组各34例。对照组患者在术后配合给予顺铂胸腔灌注,观察组患者在术后给予鸦胆子油乳与顺铂行胸腔内灌注。比较两组患者的近期疗效、并发症发生率、免疫功能指标及随访期间无进展生存时间、总生存时间及生存质量评分。结果观察组近期临床总有效率(79.41%)明显高于对照组(61.76%),差异具有统计学意义(P <0.05)。观察组并发症发生率(26.47%)与对照组患者(23.53%)相比,差异无统计学意义(P> 0.05)。观察组治疗后CD4^+CD25^+、CD4^+、CD8^+、CD4^+/CD8^+分别为(7.22±1.39)%、(39.39±5.61)%、(62.30±8.51)%、(19.89±4.25)%、(1.31±0.39),对照组治疗后CD4^+CD25^+、CD4^+、CD8^+、CD4^+/CD8^+分别为(10.12±0.89)%、(35.21±4.73)%、(54.29±7.61)%、(18.46±3.34)%、(1.14±0.39),两组患者治疗后与治疗前相比,CD4^+CD25^+降低、CD4^+升高、CD8^+升高、CD4^+/CD8^+升高,观察组患者改善更加显著,差异具有统计学意义(P <0.05)。但两组患者治疗后与治疗前相比,NK细胞水平差异无统计学意义(P> 0.05)。观察组无进展生存时间、总生存时间,生活质量评分分别为(8.12±1.78)月、(12.99±2.34)月、(70.34±5.11)分,对照组无进展生存时间、总生存时间,生活质量评分分别为(4.34±1.45)月、(9.21±2.34)月、(61.21±4.26)分,观察组无进展生存时间、总生存时间延长,生活质量评分明显高于对照组,差异均具有统计学意义(P <0.05)。结论鸦胆子油乳与顺铂行胸腔内灌注能够促进提高肺腺癌患者术后的近远期疗效,改善免疫功能,且并不增加并发症发生率,安全性较高。Objective To explore and analyze the effect of anatomical pneumonectomy combined with Brucea javanica oil and cisplatin intrathoracic infusion on immune function,short-term and long-term outcomes in patients with lung adenocarcinoma.Methods Retrospective analysis of The clinical data of 68 patients with lung adenocarcinoma undergoing anatomical pneumonectomy admitted to the Cancer Hospital of Xinjiang Medical University during March 2015 to March 2017 were retrospectively analyzed,these patients were divided into two groups according to the treatment,34 cases in each group.Patients in control group were given with cisplatin for pleural perfusion after surgery,patients in observation group after surgery to were given with Java brucea fruit oil emulsion with Cisplatin intrathoracic perfusion.The near future curative effect,rate of complications and immune function index and follow-up period progression-free survival and overall survival time and scores of quality of life had been compared between these two groups of patients.Results The total clinical effective rate( 79.41%) in observation group was significantly higher than that( 61.76%) in the control group,and the difference was statistically significant( P < 0.05).The incidence of complications in observation group( 26.47%) was not significantly different from that in control group( 23.53%)( P > 0.05).The CD4^+CD25^+,CD4^+,CD8^+,and CD4^+/CD8^+in observation group were( 7.22±1.39)%,( 39.39±5.61)%,( 62.30±8.51)%,( 19.89±4.25)%,and( 1.31 ±0.39) respectively.After treatment,CD4^+CD25^+,CD4^+,CD8^+,and CD4^+/CD8^+were( 6.12±0.89)%,( 35.21±4.73)%,( 54.29 ±7.61)%,( 18.46±3.34)%,and 1.14±0.39,respectively.In comparison with those before treatment,CD4^+CD25^+were reduced,CD4^+,CD8^+,and CD4^+/CD8^+were elevated in these two groups.The improvement was more significant in observation group( P < 0.05).However,there was no significant difference in levels of NK cells between these two groups after treatment( P > 0.05).The progression-free survival time and overal

关 键 词：肺腺癌 解剖性肺切除术 鸦胆子油乳 顺铂 胸腔内灌注 免疫功能 近期疗效 

分 类 号：R734.2[医药卫生—肿瘤]