解剖性肺切除术联合鸦胆子油乳与顺铂行胸腔内灌注对肺腺癌患者免疫功能及近远期疗效的影响
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摘要
目的探究与分析解剖性肺切除术联合鸦胆子油乳与顺铂行胸腔内灌注对肺腺癌患者免疫功能及近远期疗效的影响。方法回顾性分析2015年3月至2017年3月新疆医科大学附属肿瘤医院收治的68例接受解剖性肺切除术的肺腺癌患者的临床资料,根据治疗方法将患者分为两组,每组各34例。对照组患者在术后配合给予顺铂胸腔灌注,观察组患者在术后给予鸦胆子油乳与顺铂行胸腔内灌注。比较两组患者的近期疗效、并发症发生率、免疫功能指标及随访期间无进展生存时间、总生存时间及生存质量评分。结果观察组近期临床总有效率(79. 41%)明显高于对照组(61. 76%),差异具有统计学意义(P <0. 05)。观察组并发症发生率(26. 47%)与对照组患者(23. 53%)相比,差异无统计学意义(P> 0. 05)。观察组治疗后CD4~+CD25~+、CD4~+、CD8~+、CD4~+/CD8~+分别为(7. 22±1. 39)%、(39. 39±5. 61)%、(62. 30±8. 51)%、(19. 89±4. 25)%、(1. 31±0. 39),对照组治疗后CD4~+CD25~+、CD4~+、CD8~+、CD4~+/CD8~+分别为(10. 12±0. 89)%、(35. 21±4. 73)%、(54. 29±7. 61)%、(18. 46±3. 34)%、(1. 14±0. 39),两组患者治疗后与治疗前相比,CD4~+CD25~+降低、CD4~+升高、CD8~+升高、CD4~+/CD8~+升高,观察组患者改善更加显著,差异具有统计学意义(P <0. 05)。但两组患者治疗后与治疗前相比,NK细胞水平差异无统计学意义(P> 0. 05)。观察组无进展生存时间、总生存时间,生活质量评分分别为(8. 12±1. 78)月、(12. 99±2. 34)月、(70. 34±5. 11)分,对照组无进展生存时间、总生存时间,生活质量评分分别为(4. 34±1. 45)月、(9. 21±2. 34)月、(61. 21±4. 26)分,观察组无进展生存时间、总生存时间延长,生活质量评分明显高于对照组,差异均具有统计学意义(P <0. 05)。结论鸦胆子油乳与顺铂行胸腔内灌注能够促进提高肺腺癌患者术后的近远期疗效,改善免疫功能,且并不增加并发症发生率,安全性较高。
Objective To explore and analyze the effect of anatomical pneumonectomy combined with Brucea javanica oil and cisplatin intrathoracic infusion on immune function,short-term and long-term outcomes in patients with lung adenocarcinoma. Methods Retrospective analysis of The clinical data of 68 patients with lung adenocarcinoma undergoing anatomical pneumonectomy admitted to the Cancer Hospital of Xinjiang Medical University during March 2015 to March 2017 were retrospectively analyzed,these patients were divided into two groups according to the treatment,34 cases in each group. Patients in control group were given with cisplatin for pleural perfusion after surgery,patients in observation group after surgery to were given with Java brucea fruit oil emulsion with Cisplatin intrathoracic perfusion. The near future curative effect,rate of complications and immune function index and follow-up period progression-free survival and overall survival time and scores of quality of life had been compared between these two groups of patients. Results The total clinical effective rate( 79. 41%) in observation group was significantly higher than that( 61. 76%) in the control group,and the difference was statistically significant( P < 0. 05). The incidence of complications in observation group( 26. 47%) was not significantly different from that in control group( 23. 53%)( P > 0. 05). The CD4~+CD25~+,CD4~+,CD8~+,and CD4~+/CD8~+in observation group were( 7. 22 ± 1. 39) %,( 39. 39 ± 5. 61) %,( 62. 30 ± 8. 51) %,( 19. 89 ± 4. 25) %,and( 1. 31 ±0. 39) respectively. After treatment,CD4~+CD25~+,CD4~+,CD8~+,and CD4~+/CD8~+were( 6. 12 ± 0. 89) %,( 35. 21 ± 4. 73) %,( 54. 29 ±7. 61) %,( 18. 46 ± 3. 34) %,and 1. 14 ± 0. 39,respectively. In comparison with those before treatment,CD4~+CD25~+were reduced,CD4~+,CD8~+,and CD4~+/CD8~+were elevated in these two groups. The improvement was more significant in observation group( P < 0. 05). However,there was no significant difference in levels of NK cells between these two groups after treatment( P > 0. 05). The progression-free survival time and overall survival time of patients in observation group were( 8. 12 ± 1. 78) months,( 12. 99 ± 2. 34) months,( 70. 34 ± 5. 11) points,no progression survival time,total survival time,and quality of life in control group. The scores were( 4. 34 ± 1. 45) months,( 9. 21 ± 2. 34) months,and( 61. 21 ± 4. 26) points. In comparison with control group,the progression-free survival time,total survival time,and quality of life scores were increased. All these were statistically significant( P < 0. 05). Conclusion Java brucea fruit oil emulsion combined with cisplatin intrathoracic perfusion can promote postoperative JinYuanQi curative effect of lung adenocarcinoma patients,improve immune function and not increase the incidence of complications with high safety.
Objective To explore and analyze the effect of anatomical pneumonectomy combined with Brucea javanica oil and cisplatin intrathoracic infusion on immune function,short-term and long-term outcomes in patients with lung adenocarcinoma. Methods Retrospective analysis of The clinical data of 68 patients with lung adenocarcinoma undergoing anatomical pneumonectomy admitted to the Cancer Hospital of Xinjiang Medical University during March 2015 to March 2017 were retrospectively analyzed,these patients were divided into two groups according to the treatment,34 cases in each group. Patients in control group were given with cisplatin for pleural perfusion after surgery,patients in observation group after surgery to were given with Java brucea fruit oil emulsion with Cisplatin intrathoracic perfusion. The near future curative effect,rate of complications and immune function index and follow-up period progression-free survival and overall survival time and scores of quality of life had been compared between these two groups of patients. Results The total clinical effective rate( 79. 41%) in observation group was significantly higher than that( 61. 76%) in the control group,and the difference was statistically significant( P < 0. 05). The incidence of complications in observation group( 26. 47%) was not significantly different from that in control group( 23. 53%)( P > 0. 05). The CD4~+CD25~+,CD4~+,CD8~+,and CD4~+/CD8~+in observation group were( 7. 22 ± 1. 39) %,( 39. 39 ± 5. 61) %,( 62. 30 ± 8. 51) %,( 19. 89 ± 4. 25) %,and( 1. 31 ±0. 39) respectively. After treatment,CD4~+CD25~+,CD4~+,CD8~+,and CD4~+/CD8~+were( 6. 12 ± 0. 89) %,( 35. 21 ± 4. 73) %,( 54. 29 ±7. 61) %,( 18. 46 ± 3. 34) %,and 1. 14 ± 0. 39,respectively. In comparison with those before treatment,CD4~+CD25~+were reduced,CD4~+,CD8~+,and CD4~+/CD8~+were elevated in these two groups. The improvement was more significant in observation group( P < 0. 05). However,there was no significant difference in levels of NK cells between these two groups after treatment( P > 0. 05). The progression-free survival time and overall survival time of patients in observation group were( 8. 12 ± 1. 78) months,( 12. 99 ± 2. 34) months,( 70. 34 ± 5. 11) points,no progression survival time,total survival time,and quality of life in control group. The scores were( 4. 34 ± 1. 45) months,( 9. 21 ± 2. 34) months,and( 61. 21 ± 4. 26) points. In comparison with control group,the progression-free survival time,total survival time,and quality of life scores were increased. All these were statistically significant( P < 0. 05). Conclusion Java brucea fruit oil emulsion combined with cisplatin intrathoracic perfusion can promote postoperative JinYuanQi curative effect of lung adenocarcinoma patients,improve immune function and not increase the incidence of complications with high safety.
引文
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[4]邓杰,解明然,郭明发,等.胸苷酸合成酶检测指导肺腺癌患者术后辅助化疗的临床研究[J].安徽医科大学学报,2016,51(10):1509-1513.
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[7] Song JC,Lu ZJ,Jiao YF,et al. Etomidate Anesthesia during ERCP Caused More Stable Haemodynamic Responses Compared with Propofol:A Randomized Clinical Trial[J]. Int J Med Sci,2015,12(7):559-565.
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[10]朱述阳,康天楚,赵力,等.丝裂霉素、顺铂、沙培林联合胸腔内注入治疗肺癌恶性胸腔积液的临床研究[J].中国肺癌杂志,2012,5(5):380-382.
[11] Hoffman AJ,Brintnall RA,Brown JK,et al. Too sick not to exercise:using a 6-week,home-based exercise intervention for cancer-related fatigue self-management for postsurgical non-small cell lung cancer patients[J]. Cancer Nurs,2013,36(3):175-188.
[12]师智勇.观察多药联合预防肺癌术后辅助化疗中恶心呕吐的临床效果[J].中医临床研究,2016,8(21):128-130.
[13]袁选举,陈萍,曹风君,等.高强度超声聚焦刀联合鸦胆子油乳介入治疗中晚期肝癌35例临床观察[J].临床和实验医学杂志,2013,12(21):1765-1767.
[2]林志豪,金贞姬.沙利度胺治疗恶性肿瘤的研究进展[J].中国药业,2013,22(21):1-3.
[3] Shah SB,Chowdhury I,Bhargava AK,et al. Comparison of hemodynamic effects of intravenous etomidate versus propofol during induction and intubation using entropy guided hypnosis levels[J]. J Anaesthesiol Clin Pharmacol,2015,31(2):180-185.
[4]邓杰,解明然,郭明发,等.胸苷酸合成酶检测指导肺腺癌患者术后辅助化疗的临床研究[J].安徽医科大学学报,2016,51(10):1509-1513.
[5] Suntharalingam M,Moughan J,Coia LR,et al. The national practice for patients receiving radiation therapy for carcinoma of the esophagus:results of the 1996-1999 Patterns of Care Study[J]. Int J Radiat Oncol Biol Phys,2013,56(4):981-987.
[6]尹明秋.中心静脉导管胸腔闭式引流术在肺癌胸腔积液中的应用及护理[J].中国肿瘤临床与康复,2014,21(11):1395-1398.
[7] Song JC,Lu ZJ,Jiao YF,et al. Etomidate Anesthesia during ERCP Caused More Stable Haemodynamic Responses Compared with Propofol:A Randomized Clinical Trial[J]. Int J Med Sci,2015,12(7):559-565.
[8]刘华,戴李婷,王理槐.肺癌1号方对人肺癌小鼠移植瘤的抑制作用研究[J].中医药导报,2016,22(4):90-91.
[9]潘艳华,李舜,边文贵.中药1号方治疗晚期非小细胞肺癌30例[J].中国中医药现代远程教育,2013,11(3):52-53.
[10]朱述阳,康天楚,赵力,等.丝裂霉素、顺铂、沙培林联合胸腔内注入治疗肺癌恶性胸腔积液的临床研究[J].中国肺癌杂志,2012,5(5):380-382.
[11] Hoffman AJ,Brintnall RA,Brown JK,et al. Too sick not to exercise:using a 6-week,home-based exercise intervention for cancer-related fatigue self-management for postsurgical non-small cell lung cancer patients[J]. Cancer Nurs,2013,36(3):175-188.
[12]师智勇.观察多药联合预防肺癌术后辅助化疗中恶心呕吐的临床效果[J].中医临床研究,2016,8(21):128-130.
[13]袁选举,陈萍,曹风君,等.高强度超声聚焦刀联合鸦胆子油乳介入治疗中晚期肝癌35例临床观察[J].临床和实验医学杂志,2013,12(21):1765-1767.