重组人粒细胞巨噬细胞集落刺激因子在宫颈癌放疗致急性放射性直肠炎的临床应用  

Clinical application of recombinant human granulocyte macrophage colony-stimulating factor in acute radiation proctitis caused by radiotherapy for cervical cancer

作　　者：杨蜜 别俊 唐组阁 张加勇 邓佳秀 卢俊 YANG Mi;BIE Jun;TANG Zuge;ZHANG Jiayong;DENG Jiaxiu;LU Jun(Department of Oncology,Beijing Anzhen Nanchong Hospital,Capital Medical University,Nanchong Central Hospital,Nanchong 637000,Sichuan,China)

机构地区：[1]首都医科大学附属北京安贞医院南充医院·南充市中心医院肿瘤科,四川南充637000

出　　处：《西部医学》2024年第9期1318-1322,共5页Medical Journal of West China

基　　金：四川省科技厅2023重大专项(2023YFS0473)。

摘　　要：目的探索重组人粒细胞巨噬细胞集落刺激因子在宫颈癌放疗致急性放射性直肠炎中的临床疗效。方法分析本院2021年1月—2022年6月接受放射治疗的宫颈癌且出现急性放射性直肠炎的患者60例资料,随机分为观察组和对照组各30例。对照组给予0.9%NaCl注射液100 mL+甲硝唑氯化钠注射液100 mL+地塞米松10 mg,观察组给予0.9%NaCl注射液100 mL+甲硝唑氯化钠注射液100 mL+地塞米松10 mg+GM-CSF 150μg,均行保留灌肠。结果观察组及对照组的患者均经过对症处理后好转,好转率均为100%;两组的治愈率分别为73%(22/30)vs 60%(18/30),(χ^(2)=1.20,P=0.412);观察组及对照组症状好转所需时间分别为(7.60±2.17)d vs(8.83±1.60)d,两组之间差异均具有统计学意义(t=4.470,P=0.039);治疗第7天的CRP值两组之间具有差异(t=6.795,P=0.012),观察组更具优势;使用SOMA量表分别对患者灌肠前后进行评分,两组患者自身对比灌肠后便血、腹泻、里急后重、腹痛评分均较灌肠前明显降低(均P<0.05);分组比较两组患者灌药前后各症状评分差异均无统计学意义(均P>0.05)。两组治疗均耐受良好,无严重治疗相关毒副反应。结论重组人粒细胞巨噬细胞集落刺激因子联合保留灌肠能有效改善急性放射性肠炎患者的临床症状,并缩短治疗时间,可作为一种治疗急性放射性肠炎的新方法。Objective To explorie the clinical efficacy of recombinant human granulocyte macrophage colony stimulating factor in acute radiation proctitis caused by cervical cancer radiotherapy.Methods Analyze 60 patients with cervical cancer and acute radiation proctitis who underwent radiotherapy in our hospital from January 2021 to June 2022.Randomly divide into experimental group and control group.The control group was given 100 mL of 0.9%NaCl injection+100 mL of metronidazole sodium chloride injection+10 mg of dexamethasone,while the experimental group was given 100 mL of 0.9%NaCl injection+100 mL of metronidazole sodium chloride injection+10 mg of dexamethasone+GM-CSF 150μg.All patients underwent retention enema.Results The patients in both groups improved after symptomatic treatment,with an improvement rate of 100%;The cure rates of the two groups were 73%(22/30)vs 60%(18/30),respectively(χ^(2)2=1.20,P=0.412).The time required for symptom improvement in the experimental group and control group was(7.60±2.17)days vs(8.83±1.60)days,respectively,with significant differences between the two groups(t-value=4.470,P=0.039).On the 7th day of treatment,there was a difference in CRP values between the two groups(t=6.795,P=0.012),and the experimental group had a greater advantage.The SOMA scale was used to score patients before and after enema,and the scores of bloody stools,diarrhea,urgency,weight,and abdominal pain after enema were significantly lower in the two group compared to before enema(all P<0.05).There was no statistically significant difference in symptom scores between the two group before and after medication administration(all P>0.05).Both groups of treatments were well tolerated and there were no serious treatment related toxic side effects.Conclusion Recombinant human granulocyte macrophage colony-stimulating factor combined with retention enema can effectively improve the clinical symptoms of patients with acute radiation enteritis and shorten the treatment time,which can be used as a new method to treat acu

关 键 词：重组人粒细胞巨噬细胞集落刺激因子 急性放射性直肠炎 宫颈癌 

分 类 号：R737.33[医药卫生—肿瘤]