非霍奇金淋巴瘤患者化疗前后细胞因子水平与化疗相关认知障碍的相关性研究  

Correlation between the cytokine levels before and after chemotherapy and involved chemotherapy-induced cognitive impairment in non-Hodgkin's lymphoma patients

作　　者：李皓吾 程怀东[1] 轩菡[1] LI Haowu;CHENG Huaidong;XUAN Han(Department of Oncology,the Second Affiliated Hospital of Anhui Medical University,Anhui Hefei 230000,China)

机构地区：[1]安徽医科大学第二附属医院肿瘤科,安徽合肥230000

出　　处：《现代肿瘤医学》2023年第4期733-736,共4页Journal of Modern Oncology

基　　金：国家自然科学基金资助项目(编号:81872504)。

摘　　要：目的:研究非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)患者在化疗前后细胞因子水平与认知功能发生的变化,明确细胞因子、功能状况与认知功能之间的关联性。方法:共纳入30名NHL患者,受试者在化疗前和进行2程化疗后完成全面的心理学量表及细胞因子白细胞介素4(interleukin 4,IL-4)与白细胞介素6(interleukin 6,IL-6)评估。结果:受试者的IL-4水平在治疗前比治疗后高(t=2.85,P<0.01),而IL-6水平在治疗前比治疗后低(P<0.01)。IL-6与前瞻性记忆(prospective memory,PM)、回顾性记忆(retro⁃spective memory,RM)之间具有弱相关(r=0.282、0.270,P均<0.05),IL-6与日常认知量表(ECog-12)之间具有中度相关(r=0.314,P<0.05)。IL-4与认知之间未发现相关性。简易精神检查量表(mini-mental state examination,MMSE)、言流畅性测试(verbal fluency test,VFT)、符号数字模式测验(symbol digit modalities test,SDMT)、画钟测试(clock drowing test,CDT)、RM和卡氏评分(karnofsky performance status,KPS)之间均有中度相关(r=0.479、0.378、0.464、0.396、-0.366,P均<0.01)。结论:NHL患者的认知功能在化疗后短期时间受到损伤,表现在视空间障碍、语言及记忆方面。IL-4可能是认知功能的保护因素,而IL-6可能是认知功能的损伤因素。NHL认知功能的管理及改善将有助于提高KPS水平,从而提高患者的生存质量与对化疗的耐受程度。Objective:To investigate,the changes of cytokine levels and cognitive function in patients with non-Hodgkin's lymphoma(NHL)before and after chemotherapy to clarify the correlation between cytokines,functional sta⁃tus and cognitive function.Methods:A total of 30 patients with NHL were included in this study.These patients com⁃pleted cognitive assessment and cytokine levels which including interleukin 4(IL-4)and interleukin 6(IL-6)be⁃fore chemotherapy and after 2 courses of chemotherapy.Results:The IL-4 level of patients was higher before treat⁃ment than after treatment(t=2.85,P<0.01),and IL-6 level was lower before treatment than after treatment(P<0.01).IL-6 had a weak correlation with retrospective memory(RM)and prospective memory(PM)(r=0.282 and 0.270,respectively,all P<0.05).There was a moderate correlation between IL-6 and ECog-12(r=0.314,P<0.05),but no statistical association was found between cognition and IL-4.There was a moderate correlation be⁃tween subjects'cognition(MMSE,VFT,SDMT,CDT,RM)and KPS(r=0.479,0.378,0.464,0.396 and-0.366,re⁃spectively,all P<0.01).Conclusion:The cognitive function of NHL patients is impaired in a short time after chemo⁃therapy,which is manifested in visuospatial disturbance,language and memory.IL-4 may be a protective factor of cognitive function,and IL-6 may be a factor of impairment of cognitive function.Management and improvement of cognitive function in NHL will help to improve KPS levels.

关 键 词：非霍奇金淋巴瘤 化疗相关认知障碍 细胞因子 卡氏功能状态评分 

分 类 号：R733.4[医药卫生—肿瘤]