摘要
目的探讨艾迪注射液联合mFOLFOX6方案对晚期结直肠癌化疗患者T淋巴细胞水平及化疗安全性的影响。方法选取佳木斯市中心医院的90例晚期结直肠癌患者作为研究对象,随机分为常规组和联合组,每组各45例。所有患者均给予止吐等支持治疗,常规组接受mFOLFOX6化疗方案,联合组在此基础上联合艾迪注射液治疗。比较两组治疗前后T淋巴细胞亚群水平,血清miR-21、miR-103、miR-200b变化情况及化疗安全性。结果常规组与联合组性别、年龄、身体质量指数、卡氏评分、临床分期及原发部位基线资料比较差异均无统计学意义(P>0.05)。联合组疗效分布明显优于常规组,疾病控制率高于常规组,差异有统计学意义(Z/χ^(2)值分别为6.36、4.45,P值均<0.05)。治疗前常规组与联合组T淋巴细胞亚群比较差异均无统计学意义(P>0.05);治疗后,联合组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)明显高于常规组,CD8^(+)明显低于常规组,差异均有统计学意义[(654.32±98.33)个/μL比(426.21±80.03)个/μL,(869.45±79.35)个/μL比(667.33±75.30)个/μL,(0.83±0.15)个/μL比(0.56±0.10)个/μL,(1052.46±182.51)个/μL比(1189.73±153.67)个/μL,t值分别为12.07、12.40、10.05、3.86,P值均<0.001]。治疗前常规组与联合组血清miR-21、miR-103、miR-200b比较差异均无统计学意义(P>0.05);治疗后,联合组血清miR-21、miR-103明显低于常规组,miR-200b明显高于常规组,差异均有统计学意义[(2.46±0.28)比(3.60±0.22),(1.94±0.29)比(2.62±0.18),(0.88±0.14)比(0.62±0.11),t值分别为21.48、13.36、9.80,P值均<0.001]。与常规组相比,联合组化疗恶心、便秘、脱发、骨髓抑制等不良反应分度严重程度明显降低(Z/χ^(2)值分别为6.46、6.34、5.38、4.90,P值均<0.05),恶心总发生率明显降低(χ^(2)=10.02,P<0.001)。结论艾迪注射液联合mFOLFOX6化疗方案可增强晚期结直肠癌治疗疗效,避免化疗所致的T淋巴细胞亚群水平紊乱、调节miR-21、miR-103、miR-200b水平,减轻化疗相关不良反应。
Objective To investigate the effect of Addi injection combined with mFOLFOX6 regimen on the level of T lymphocytes and the safety of chemotherapy in patients with advanced colorectal cancer undergoing chemotherapy.Methods A total of 90 patients with advanced colorectal cancer from the First Department of Oncology,Jiamusi Central Hospital were selected as the research subjects,and they were randomly divided into a conventional group and a combined group,with 45 cases in each group.All patients were given antiemetic and other supportive treatment.The routine group received mFOLFOX6 chemotherapy regimen.The combination group was treated with Aidi injection on the basis of mFOLFOX6 chemotherapy.The levels of T lymphocyte subsets,the changes of serum miR-21,miR-103 and mir-200b,and the safety of chemotherapy were compared between the two groups before and after treatment.Results There were no significant differences in gender,age,body mass index,Karnofsky score,clinical stage and baseline data of primary site between the conventional group and the combined group(P>0.05).The curative effect distribution of the combination group was significantly better than that of the conventional group,and the disease control rate was higher than that of the conventional group(Z/χ^(2) values were 6.36 and 4.45 respectively,both P values<0.05).Before treatment,there was no significant difference in T lymphocyte subsets between the conventional group and the combination group(P>0.05).After treatment,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)in the combined group were significantly higher than those in the routine group,and CD8^(+)was significantly lower than those in the routine group[(654.32±98.33)pieces/μL vs(426.21±80.03)pieces/μL,(869.45±79.35)pieces/μL vs(667.33±75.30)pieces/μL,(0.83±0.15)pieces/μL vs(0.56±0.10)/μL,(1052.46±182.51)pieces/μL vs(1189.73±153.67)pieces/μL,t values were 12.07,12.40,10.05 and 3.86 respectively,all P values<0.001].Before treatment,there was no significant difference in serum miR-21,miR-103 and miR-200b between the conventional group and the combined group(P>0.05).After treatment,the serum miR-21 and miR-103 in the combined group were significantly lower than those in the conventional group,and miR-200b was significantly higher than the conventional group[(2.46±0.28)vs(3.60±0.22),(1.94±0.29)vs(2.62±0.18),(0.88±0.14)vs(0.62±0.11),t values were 21.48、13.36 and 9.80 respectively,all P values<0.001].Compared with the conventional group,the severity of adverse reactions such as nausea,constipation,alopecia,and bone marrow suppression in the combination group was significantly reduced(Z/χ^(2) values were 6.46,6.34,5.38 and 4.90 respectively,all P values<0.05),and the total incidence of nausea decreased significantly(χ^(2)=10.02,P<0.001).Conclusion Aidi injection combined with mFOLFOX6 chemotherapy regimen can enhance the therapeutic effect of advanced colorectal cancer,avoid the disorder of T lymphocyte subsets caused by chemotherapy,regulate the levels of miR-21,miR-103 and miR-200b,and reduce the adverse reactions related to chemotherapy.
作者
李明
杨周
孙宏建
Li Ming;Yang Zhou;Sun Hongjian(The First Department of Oncology Surgery,Jiamusi Central Hospital,Jiamusi 154002,China;The Second Department of Gastroenterology,Jiamusi Central Hospital,Jiamusi 154002,China)
出处
《国际免疫学杂志》
CAS
2022年第3期278-285,共8页
International Journal of Immunology
