核糖核酸Ⅱ用于阿那曲唑治疗乳腺癌所致骨关节症状的临床观察
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摘要
目的探讨免疫调节剂核糖核酸Ⅱ用于阿那曲唑治疗乳腺癌所致骨关节症状的临床疗效。方法选择156例绝经后Ⅰ~Ⅲ期女性乳腺癌经阿那曲唑治疗引发骨关节症状患者,分为核糖核酸Ⅱ组(给予核糖核酸Ⅱ200 mg,静滴,每日1次,治疗4周)和对照组(给予生理盐水),采用FACT-G量表、WOMAC指数评价症状变化程度,采用ELISA方法检测治疗前后外周血清中的细胞因子干扰素γ(IFN-γ)、白细胞介素-4(IL-4)、骨钙素(BGP)、骨碱性磷酸酶(BALP)、Ⅰ型胶原羧基端前肽(CICP)含量。结果与对照组比较,使用核糖核酸Ⅱ治疗后,患者的骨关节病变、疼痛程度和生活质量均明显改善(P<0.05),IL-4水平升高、IFN-γ水平降低(P<0.05),骨代谢指标BALP、CICP含量明显降低(P<0.05)。结论核糖核酸Ⅱ能够改善芳香化酶抑制剂治疗相关的骨关节症状,其机制可能与免疫调节作用有关。
Objective To investigate the effect of immunomodulator ribonucleic acid Ⅱ on anastrozole-related joint symptoms. Methods A total of 156 postmenopausal women patients with stage Ⅰ-Ⅲ breast cancer and anastrozole-related joint symptoms were enrolled. These patients were divided into two groups: One group were treated by ribonucleic acid Ⅱ( 200 mg,intravenous infusion,1 time a day) as the experimental group,the other was treated by saline as the control group. The degree of symptom change was evaluated by FACT-G and WOMAC. The levels of serum cytokines( IFN-γ and IL-4),the bone gla protein( BGP),bone alkaline phosphatase( BALP) and I collagen carboxyl-terminal propeptide( CICP) of bone metabolism were detected by ELISA method. Results In comparison with the control group,ribonucleic acid Ⅱ significantly reduced the severity of musculoskeletal symptoms and pain,and also improved the quality of life( P < 0. 05). In ribonucleic acid Ⅱ group,the blood level of IL-4 was increased,whereas IFN-γwas decreased( P < 0. 05). as well as,the indexes of bone metabolism BALP and CICP were significantly lower than those in the control group( P < 0. 05). Conclusion Ribonucleic acid Ⅱ could improve aromatase inhibitor related musculoskeletal symptoms by the role of immunity adjustment.
Objective To investigate the effect of immunomodulator ribonucleic acid Ⅱ on anastrozole-related joint symptoms. Methods A total of 156 postmenopausal women patients with stage Ⅰ-Ⅲ breast cancer and anastrozole-related joint symptoms were enrolled. These patients were divided into two groups: One group were treated by ribonucleic acid Ⅱ( 200 mg,intravenous infusion,1 time a day) as the experimental group,the other was treated by saline as the control group. The degree of symptom change was evaluated by FACT-G and WOMAC. The levels of serum cytokines( IFN-γ and IL-4),the bone gla protein( BGP),bone alkaline phosphatase( BALP) and I collagen carboxyl-terminal propeptide( CICP) of bone metabolism were detected by ELISA method. Results In comparison with the control group,ribonucleic acid Ⅱ significantly reduced the severity of musculoskeletal symptoms and pain,and also improved the quality of life( P < 0. 05). In ribonucleic acid Ⅱ group,the blood level of IL-4 was increased,whereas IFN-γwas decreased( P < 0. 05). as well as,the indexes of bone metabolism BALP and CICP were significantly lower than those in the control group( P < 0. 05). Conclusion Ribonucleic acid Ⅱ could improve aromatase inhibitor related musculoskeletal symptoms by the role of immunity adjustment.
引文
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[16]王长琴,赵冬梅.老年患者使用核糖核酸Ⅱ的疗效观察[J].实用药物与临床,2013,16(3):260-261.
[17]赵红,张清媛,王静萱,等.芳香化酶抑制剂相关骨关节症状的免疫调节机制研究[J].临床肿瘤学杂志,2011,16(7):582-585.
[18]陈宗义,王慧静,胡小池.注射用核糖核酸Ⅱ在乳腺癌化疗的临床效果[J].吉林医学,2012,33(18):3892.
[2]Jochems C,Islander U,Erlandsson M,et al.Role of endogenous and exogenous female sex hormones in arthritis and osteoporosis development in B10.Q-ncf1 mice with collagen-induced chronic arthritis[J].BMC Musculoskelet Disord,2010,11:284.
[3]Zhang QY,Tang DB,Zhao H.Immunological therapies can relieve aromatase inhibitor-related joint symptoms in breast cancer survivors[J].Am J Clin Oncol,2010,33(6):557-560.
[4]Wong CK,Lam CL,Rowen D,et al.Mapping the functional assessment of cancer therapy-general or-colorectal to SF-6D in Chinese patients with colorectal neoplasm[J].Value Health,2012,15(3):495-503.
[5]Ebrahimzadeh MH,Makhmalbaf H,Birjandinejad A,et al.The Western Ontario and Mc Master Universities Osteoarthritis Index(WOMAC)in persian speaking patients with knee osteoarthritis[J].Arch Bone Jt Surg,2014,2(1):57-62.
[6]Partridge AH,La Fountain A,Mayer E,et al.Adherence to initial adjuvant anastrozole therapy among women with early-stage breast cancer[J].J Clin Oncol,2008,26(4):556-562.
[7]Odermatt R,Wolfer A,Zaman K.Endocrine therapy in breast cancer:efficacy and adverse events[J].Revue médicale Suisse,2013,9(387):1090-1094.
[8]Bradley CJ,Dahman B,Jagsi R,et al.Prescription drug coverage:implications for hormonal therapy adherence in women diagnosed with breast cancer[J].Breast Cancer Res Treat,2015,154(2):417-422.
[9]Halsey EJ,Xing M,Stockley RC.Acupuncture for joint symptoms related to aromatase inhibitor therapy in postmenopausal women with early-stage breast cancer:a narrative review.Acupunct Med,2015,33(3):188-195.
[10]Minett MS,Falk S,Santana-Varela S,et al.Pain without nociceptors?Nav1.7-independent pain mechanisms[J].Cell Rep,2014,6(2):301-312.
[11]Wang J,Zhang Q,Jin S,et al.Immoderate inhibition of estrogen by anastrozole enhances the severity of experimental polyarthritis[J].Exp Gerontol,2009,44(6-7):398-405.
[12]Giefing-Krll C,Berger P,Lepperdinger G,et al.How sex and age affect immune responses,susceptibility to infections,and response to vaccination[J].Aging Cell,2015,14(3):309-321.
[13]He F,Balling R.The role of regulatory T cells in neurodegenerative diseases[J].Wiley Interdiscip Rev Syst Biol Med,2013,5(2):153-180.
[14]Redzovic'A,Dintinjana RD,Nacinovic'AD.Indicators of cellular and developmental disorders in multiple primary cancers[J].Coll Antropol,2016,40(1):59-62.
[15]陈忠华.注射用核糖核酸对小鼠免疫功能的影响[J].药学实践杂志,2008,26(1):28-30.
[16]王长琴,赵冬梅.老年患者使用核糖核酸Ⅱ的疗效观察[J].实用药物与临床,2013,16(3):260-261.
[17]赵红,张清媛,王静萱,等.芳香化酶抑制剂相关骨关节症状的免疫调节机制研究[J].临床肿瘤学杂志,2011,16(7):582-585.
[18]陈宗义,王慧静,胡小池.注射用核糖核酸Ⅱ在乳腺癌化疗的临床效果[J].吉林医学,2012,33(18):3892.