脾多肽对晚期肺癌化疗患者肺部感染的疗效及免疫功能的影响  

Effect of lienal polypeptide on treatment of advanced lung cancer and chemotherapy patients with pulmonary infection and impact on immune function

作　　者：薛华 魏胜全[2] 翟梅 王智杰 李满祥[3] 张燕 XUE Hua;WEI Sheng-quan;ZHAI Mei;WANG Zhi-jie;LI Man-xiang;ZHANG Yan(Xianyang First People′s Hospital,Xianyang,Shaanxi 712000,China;不详)

机构地区：[1]咸阳市第一人民医院呼吸科,陕西咸阳712000 [2]宝鸡市人民医院呼吸科,陕西宝鸡721000 [3]西安交通大学第一附属医院呼吸科,陕西西安710000 [4]咸阳市彬县县医院呼吸科,陕西咸阳713500

出　　处：《中华医院感染学杂志》2020年第9期1355-1359,共5页Chinese Journal of Nosocomiology

基　　金：陕西省卫生厅科研基金资助项目(2014JM50226)。

摘　　要：目的分析脾多肽对晚期肺癌化疗患者肺部感染的疗效及免疫功能的影响,为临床治疗工作提供研究依据。方法选取2018年3月-2019年3月咸阳市第一人民医院收治的186例晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗后合并医院获得性肺炎(hospital acquired pneumonia,HAP)患者,采用随机数字表法将其分为研究组和对照组,每组93例。两组患者均给予常规对症治疗,研究组患者同时给予脾多肽注射液,连续用药7 d。对两组患者的咳嗽消失时间、咳痰消失时间、体温恢复正常时间、肺部啰音消失时间、抗菌药物应用时间等指标进行观察和对比;对治疗前及治疗7 d时两组患者的炎症指标中血清C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、外周血白细胞计数(white blood cell,WBC)和免疫指标中CD4^+、CD8^+、CD4^+/CD8^+、自然杀伤(natural killer,NK)细胞比例进行检测和对比。结果研究组患者咳嗽与咳痰和肺部啰音消失时间、体温恢复正常时间、抗菌药物应用时间均较对照组缩短(均P<0.05);在治疗后,两组患者的各项炎症指标水平均下降,免疫指标CD4^+T淋巴细胞比例、NK细胞比例、CD4^+/CD8^+比值均上升,CD8^+T淋巴细胞比例均下降(均P<0.05);研究组患者上述指标的改善幅度均高于对照组患者(均P<0.05)。结论应用脾多肽辅助治疗晚期NSCLC化疗合并HAP患者,能够快速缓解临床症状和体征,提升免疫功能,降低炎症反应水平,有利于改善患者的预后。OBJECTIVE To observe the effect of lineal polypeptide on treatment of advanced lung cancer and chemotherapy patients with pulmonary infection and analyze the impact on immune function so as to provide guidance for clinical treatment.METHODS A total of 186 patients with advanced non-small cell lung cancer(NSCLC)who were complicated with hospital-acquired pneumonia(HAP)and treated in Xianyang First People′s Hospital from Mar 2018 to Mar 2019 were enrolled in the study and randomly divided into the study group and the control group,with 93 cases in each.The patients of both groups were given conventional symptomatic therapy,the study group was given additional lienal polypeptide injection for 7 consecutive days.The time of disappearance of cough,time of disappearance of expectoration,time of recovery of body temperature,time of disappearance of pulmonary rales and time of use of antibiotics were observed and compared between the two groups of patients;the levels of serum C-reactive protein(CRP),procalcitonin(PCT)and white blood cell(WBC)as well as immunologic indexes CD4^+,CD8^+,CD4^+/CD8^+and natural killer(NK)cell were detected and compared between the two groups of patients before the treatment and after the treatment for 7 days.RESULTS The time of disappearance of cough,time of disappearance of expectoration,time of recovery of body temperature,time of disappearance of pulmonary rales and time of use of antibiotics of the study group were significantly shorter than those of the control group(all P<0.05).The levels of the inflammatory indexes of the two groups of patients were significantly reduced after the treatment,the percentage of CD4^+T lymphocyte,percentage of NK cell and ratio of CD4^+to CD8^+were significantly elevated,the percentage of CD8^+T lymphocyte was significantly reduced(all P<0.05);the above indexes of the study group were improved more significantly than those of the control group(all P<0.05).CONCLUSION The adjuvant treatment with lienal polypeptide may rapidly relieve the clinical symptoms

关 键 词：脾多肽 非小细胞肺癌 化疗 医院获得性肺炎 免疫功能 

分 类 号：R734.2[医药卫生—肿瘤]