高压氧辅助化疗联合免疫治疗对胃癌腹膜转移患者临床疗效及免疫应答水平的影响  

Clinical efficacy of hyperbaric oxygen-assisted chemotherapy combined with immunotherapy and its impact on immune response level in patients with peritoneal metastasis of gastric cancer

作　　者：吴世民 陈秀娣 项利娟 Wu Shimin;Chen Xiudi;Xiang Lijuan(Department of Gastroenterology,Shangyu People’s Hospital of Shaoxing,Shangyu312300,China;Hyperbaric Oxygen Diagnosis and Treatment Center,Shangyu People’s Hospital of Shaoxing,Shangyu312300,China)

机构地区：[1]绍兴市上虞人民医院消化内科,上虞312300 [2]绍兴市上虞人民医院高压氧诊疗中心,上虞312300

出　　处：《中华航海医学与高气压医学杂志》2024年第6期752-756,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：浙江省中医药科技项目(2024ZL181);浙江省医药卫生科技计划项目(2021KY1166);绍兴市卫生健康科技计划(2023SKY113)。

摘　　要：目的探讨高压氧辅助化疗联合免疫治疗对胃癌腹膜转移患者临床疗效及免疫应答水平的影响。方法2020年5月至2023年5月便利选取绍兴市上虞人民医院消化内科确诊为胃癌腹膜转移患者142例,均行化疗联合免疫治疗,根据是否接受高压氧辅助治疗分为研究组63例和对照组79例,并于治疗前后比较2组患者的心理指标[抑郁自评量表(SDS)、焦虑自评量表(SAS)、匹兹堡睡眠质量指数(PSQI)]、药物毒性分级、细胞因子[白细胞介素(IL)-2、IL-4、IL-10、IL-37、IL-39、干扰素-γ(INF-γ)及免疫细胞(CD3T^(+)、CD4T^(+)、CD8T^(+)、NK细胞含量及CD4T^(+)/CD8T^(+)]水平。结果研究组治疗有效率(53.97%)高于对照组(39.24%),药物毒性分级得分[(1.24±0.19)分]低于对照组[(3.04±0.28)分],差异均有统计学意义(P<0.05);治疗后,2组患者的SDS、SAS和PSQI评分均低于治疗前,且研究组低于对照组同期,差异均有统计学意义(P<0.05);治疗后,研究组患者的IL-2、IL-10水平高于对照组,CD4T^(+)、NK细胞含量及CD4T^(+)/CD8T^(+)高于对照组,IL-4、IL-37、IL-39和INF-γ水平低于对照组,差异均有统计学意义(P<0.05)。结论高压氧辅助化疗联合免疫治疗对胃癌腹膜转移患者不仅具有良好的治疗效果,还有助于减轻患者药物毒性反应和负面情绪,提升免疫应答水平。Objective To study the clinical efficacy of hyperbaric oxygen-assisted chemotherapy combined with immunotherapy and its impact on immune response level in patients with peritoneal metastasis of gastric cancer.Methods From May 2020 to May 2023,a total of 142 patients diagnosed with peritoneal metastasis of gastric cancer in the Department of Gastroenterology of Shangyu People’s Hospital of Shaoxing were conveniently selected.All of them received chemotherapy combined with immunotherapy.According to whether they received hyperbaric oxygen-assisted treatment,they were divided into a study group(n=63)and a control group(n=79).Before and after treatment,the psychological indicators[self-rating depression scale(SDA),self-rating anxiety scale(SAS),Pittsburgh sleep quality index(PSQI)],clinical efficacy,drug toxicity grading,cytokine levels[interleukin(IL)-2,IL-4,IL-10,IL-37,IL-39,and INF-γ)and immune cell levels(CD3T^(+),CD4T^(+),CD8T^(+),NK cell contents,and CD4T^(+)/CD8T^(+)]of the two groups of patients were compared.Results The effective rate of treatment in the study group(53.97%)was higher than that in the control group(39.24%),and the drug toxicity grading score[(1.24±0.19)points]was lower than that in the control group[(3.04±0.28)points],and the differences were statistically significant(P<0.05).After treatment,the scores of SDA,SAS,and PSQI in both groups were lower than those before treatment,and those in the study group were lower than those in the control group at the same time point,and the differences were statistically significant(P<0.05).After treatment,the levels of IL-2 and IL-10 in the study group were higher than those in the control group,the level of CD4T^(+),NK cells contents,and CD4T^(+)/CD8T^(+)were higher than those in the control group,and the levels of IL-4,IL-37,IL-39,and INF-γwere lower than those in the control group,and the differences were all statistically significant(P<0.05).Conclusion Hyperbaric oxygen-assisted chemotherapy combined with immunotherapy not only has a good therape

关 键 词：高压氧 化疗 免疫治疗 胃癌 腹膜转移 免疫应答 

分 类 号：R735.2[医药卫生—肿瘤]