重组人粒细胞巨噬细胞集落刺激因子辅助治疗鼻咽癌放疗后口咽部感染效果  

Effect of recombinant human granulocyte macrophage colony stimulating factor on oropharyngeal infection after radiotherapy of nasopharyngeal carcinoma

作　　者：林逢春[1,4] 马冉 曹帆 梁恒坡[1,4] 韩倩[1,4] LIN Feng-chun;MA Ran;CAO Fan;LIANG Heng-po;HAN Qian(Henan Provincial People's Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南省人民医院肿瘤中心,河南郑州450003 [2]郑州大学人民医院肿瘤中心,河南郑州450003 [3]河南省人民医院药学部,河南郑州450003 [4]郑州大学人民医院药学部,河南郑州450003 [5]河南省人民医院呼吸与危重症医学科,河南郑州450003 [6]郑州大学人民医院呼吸与危重症医学科,河南郑州450003

出　　处：《中华医院感染学杂志》2021年第16期2491-2496,共6页Chinese Journal of Nosocomiology

基　　金：河南省重点科技攻关基金资助项目(152102310143)。

摘　　要：目的探讨重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)辅助常规抗感染治疗在鼻咽癌放疗后口咽部感染患者中的应用效果,为临床治疗提供数据支持。方法选取河南省人民医院2017年1月-2019年9月收治的鼻咽癌放疗后口咽部感染患者106例,按照随机数字表法分试验组、对照组,各53例。对照组采取常规抗感染治疗,试验组采取rhGM-CSF辅助常规抗感染治疗。比较两组治疗前、治疗2周、治疗4周后口腔与咽部疼痛(VAS)评分、血清炎性因子[白细胞介素-2(IL-2)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)]、口腔黏膜pH值、Toll样受体9(TLR-9)、β防御素2(hBD-2)水平、口咽舒适度评分及治疗前、治疗4周后生存质量(EORTC QLQ-C30)评分。结果治疗2周、4周后试验组口腔、咽部VAS评分低于对照组(P<0.05);治疗2周、4周后试验组血清IL-2、CRP、TNF-α、IFN-γ水平、口腔黏膜TLR-9、hBD-2表达水平均低于对照组,pH值高于对照组(P<0.05);试验组治疗4周后健康状况、功能评分高于对照组,症状评分、单项评分低于对照组(P<0.05)。结论rhGM-CSF辅助常规抗感染治疗在鼻咽癌放疗后口咽部感染患者中的应用效果较为理想,通过减轻炎症反应及口腔黏膜炎性损伤缓解口腔、咽部疼痛症状,提高口咽舒适度,进而使患者生存质量得到明显改善。OBJECTIVE To investigate the application effect of recombinant human granulocyte macrophage colony stimulating factor(rhGM-CSF)assisting conventional anti-infective therapy in patients with oropharyngeal infection after radiotherapy for nasopharyngeal carcinoma,and to provide data support for clinical treatment.METHODS A total of 106 patients with oropharyngeal infection after radiotherapy for nasopharyngeal carcinoma who were admitted to our hospital from Jan 2017 to Sep 2019 were enrolled.According to the random number table,they were divided into the observation group and control group,with 53 cases in each group.The control group was given conventional anti-infective treatment,and the observation group was given rhGM-CSF as an adjuvant to conventional anti-infective treatment.The oral and pharyngeal visual analogue scale(VAS)pain scores,serum inflammatory factors,such as interleukin-2(IL-2),C-reactive protein(CRP),tumor necrosis factor(TNF-α)and interferon-γ(IFN-γ),the pH value of the oral mucosa,Toll-like receptor 9(TLR-9),βdefensin 2(hBD-2)levels and oropharyngeal comfort scores before the treatment,2 weeks and 4 weeks after the treatment between groups were compared,and quality of life(EORTC QLQ-C30)scores before the treatment and 4 weeks after the treatment were also compared.RESULTS Compared with before treatment,the VAS pain scores of the oral cavity and pharynx and oropharyngeal comfort scores in the two groups were significantly reduced 2 and 4 weeks after the treatment,and that in the observation group was significantly lower than that in the control group(P<0.05).The serum levels of IL-2,CRP,TNF-α,IFN-γ,oral mucosa TLR-9 and hBD-2 expression levels in the observation group were significantly lower than those in the control group 2 and 4 weeks after the treatment,and pH value was significantly higher than that in the control group(P<0.05).Compared with before treatment,The health status,function score,symptom score,and individual scores in the observation group were significantly higher than th

关 键 词：鼻咽癌 放疗 口咽部感染 重组人粒细胞巨噬细胞集落刺激因子 抗感染治疗 口腔黏膜pH 炎性损伤 

分 类 号：R739.6[医药卫生—肿瘤]