摘要
目的探讨血浆中TNF-α、IL-6、ACE水平及DVH参数与放射性肺炎发生的相关性。方法选取2016年4月～2017年4月我院收治的150例胸部肿瘤患者作为研究对象,均行调强放射治疗及三维适形放射治疗,并进行细胞因子检测。比较放疗前后患者TNF-α、IL-6及ACE细胞因子水平的变化以及未发生放射性肺炎的患者与发生放射性肺炎患者DVH参数(V10、V20、V30及MLD)。结果放疗中,血浆中TNF-α以及IL-6水平高于放疗前[(17.32±5.64)pg/ml vs(11.97±4.29)pg/ml,(5.23±2.67)pg/ml vs(4.98±1.47)pg/ml],ACE水平低于放疗前[(20.15±1.61)pg/ml vs(21.02±3.41)pg/ml],差异有统计学意义(P<0.05)。发生放射性肺炎组TNF-α以及IL-6水平高于未发生放射性肺炎组[(17.39±5.74)pg/ml vs(11.81±4.39)pg/ml,(5.25±2.77)pg/ml vs(4.86±1.57)pg/ml],ACE水平低于未发生放射性肺炎组[(20.17±1.71)pg/ml vs (21.09±3.51)pg/ml],差异有统计学意义(P<0.05)。发生放射性肺炎组V10、V20、V30及MLD高于未发生放射性肺炎组,差异有统计学意义(P<0.05)。结论放射治疗后,患者体内炎症反应加强,患者肺部损伤程度加重,而发生放射性肺炎患者的DVH参数明显增加。
Objective To investigate the correlation between plasma levels of TNF-α, IL-6, ACE and DVH parameters and radiation pneumonitis. Methods A total of 150 patients with chest tumors admitted to our hospital from April 2016 to April 2017 were enrolled in the study. All patients underwent intensity-modulated radiation therapy and three-dimensional conformal radiotherapy, and cytokine tests were performed. The changes of TNF-α, IL-6 and ACE cytokine levels in patients before and after radiotherapy and the DVH parameters (V10, V20, V30 and MLD) of patients with no radiation pneumonitis and those with radiation pneumonitis were compared.Results In radiotherapy, plasma levels of TNF-α and IL-6 were higher than those before radiotherapy [(17.32±5.64) pg/ml vs (11.97±4.29) pg/ml,(5.23±2.67) pg/ml vs (4.98±1.47) pg/ml], ACE levels were lower than before radiotherapy [(20.15±1.61) pg/ml vs (21.02±3.41) pg/ml], the difference was statistically significant (P<0.05). The levels of TNF-α and IL-6 in the radioactive pneumonia group were higher than those in the non-radioactive pneumonia group [(17.39±5.74) pg/ml vs (11.81±4.39) pg/ml,(5.25±2.77) pg/ml vs (4.86± 1.57) g/ml], the ACE level was lower than that in the non-radioactive pneumonia group [(20.17±1.71) pg/ml vs (21.09±3.51) pg/ml], the difference was statistically significant (P<0.05). The incidence of V10, V20, V30 and MLD in the radioactive pneumonia group was higher than that in the non-radioactive pneumonia group,the difference was statistically significant (P<0.05).Conclusion After radiotherapy, the inflammatory response in patients is strengthened, the degree of lung injury is aggravated, and the DVH parameters of patients with radiation pneumonitis are significantly increased.
作者
卢俊
邓佳秀
秦娟
陈巧玲
潘荣强
LU Jun;DENG Jia-xiu;QIN Juan;CHEN Qiao-ling;PAN Rong-qiang(Department of Oncology,Nanchong Central Hospital/The Second Clinical College,Chuanbei Medical College,Nanchong 637000,Sichuan,China)
出处
《医学信息》
2019年第10期78-80,90,共4页
Journal of Medical Information
