乳腺癌术后化疗时机对患者免疫功能及生活质量的影响  

Effects of timing of chemotherapy after breast cancer surgery on patient's immune function and quality of life

作　　者：刘道同[1] Daotong Liu(People's Hospital,Jining 272000,Shandong Province,China)

机构地区：[1]济宁市第一人民医院乳甲外科,济宁272000

出　　处：《中国基层医药》2023年第1期35-38,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:观察乳腺癌术后不同化疗时机对患者免疫功能及生活质量的影响。方法:选取济宁市第一人民医院2017年1月至2019年1月行乳腺癌改良根治术后接受化疗的患者100例,采用随机数字表法分为对照组、早期组各50例,对照组术后4~6周开始化疗,早期组术后2周开始化疗,两组化疗方案一致。观察两组化疗前后CD4 +、CD8 +、CD4 +/CD8 +及血清免疫球蛋白A(IgA)、IgG水平,记录患者化疗不良反应及感染发生情况,评估两组末次随访时的生活质量。 结果:化疗前,两组CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)及血清IgA、lgG差异均无统计学意义(均 P > 0.05)。化疗后,早期组CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)分别为(51.76±5.21)%、(2.00±0.25),高于对照组的(48.21±4.78)%、(1.70±0.21),CD_(8)^(+)为(25.93±2.43)%,低于对照组的(28.29±2.31)%,血清IgA、lgG分别为(3.24±0.38)g/L、(9.27±1.04)g/L,明显高于对照组的(2.75±0.37)g/L、(8.43±0.97)g/L,两组比较,差异均有统计学意义( t=3.55、4.98、6.50、6.53、4.18,均 P < 0.05)。化疗期间两组不良反应发生率差异均无统计学意义(均 P > 0.05),早期组感染发生率均显著低于对照组(均 P < 0.05)。末次随访时,早期组生活质量综合问卷(GQOLI-74)各项评分均显著高于对照组(均 P < 0.05)。 结论:早期化疗可显著减轻化疗对乳腺癌术后患者免疫功能的影响,降低感染发生率,提高患者生活质量。Objective To investigate the effects of the timing of chemotherapy after breast cancer surgery on patient's immune function and quality of life.Methods A total of 100 patients who underwent modified radical mastectomy for breast cancer from January 2017 to January 2019 in Jining No.1 People's Hospital were included in this study.These patients were randomly divided into a control group and an early chemotherapy group(n=50/group).Patients in the control group underwent chemotherapy 4-6 weeks after surgery.Patients in the early chemotherapy group received chemotherapy 2 weeks after surgery.The chemotherapy regimens were the same in the two groups.The levels of CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),immunoglobulin A(IgA),and immunoglobulin G(IgG)were measured before and after chemotherapy in each group.Chemotherapy-related reverse reactions and infections were recorded.The quality of life was evaluated in each group at the last follow-up.Results Before chemotherapy,there were no significant differences in CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),IgA,and IgG levels between the two groups(all P>0.05).After chemotherapy,CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)levels in the early chemotherapy group were(51.76±5.21)%and(2.00±0.25),respectively,which were significantly higher than(48.21±4.78)%and(1.70±0.21)in the control group(t=3.55,4.98,both P<0.05).After chemotherapy,the CD_(8)^(+)level in the early chemotherapy group was(25.93±2.43)%,which was significantly lower than(28.29±2.31)%in the control group(t=6.50,P<0.05).Serum IgA and IgG levels in the early chemotherapy group were(3.24±0.38)g/L and(9.27±1.04)g/L,respectively,which were significantly higher than(2.75±0.37)g/L and(8.43±0.97)g/L in the control group(t=6.53,4.18,both P<0.05).During chemotherapy,there was no significant difference in the incidence of reverse reactions between the two groups(all P>0.05).The incidence of infections was significantly lower in the early chemotherapy group than the control group(P<0.05).At the last follow-up,generic qua

关 键 词：乳腺肿瘤 抗肿瘤联合化疗方案 手术后期间 时间因素 药物疗法 T淋巴细胞 免疫球蛋白A 免疫球蛋白G 生活质量 

分 类 号：R737.9[医药卫生—肿瘤]