鸦胆子油乳注射液联合胸腺五...驱动基因非小细胞肺癌的效果_朱杰.pdf

临床医学研究与实践2023 年 3 月第 8 卷第 7 期Effect of brucea javanica oil emulsion injection combined with thymopentinin the palliative treatment of stage non-small cell lung cancerwithout driver geneZHU Jie(Oncology Department,Taizhou City Hospital of Traditional Chinese and Western Medicine,Taizhou 225300,China)ABSTRACT:Objective To analyze the effect of brucea javanica oil emulsion injection combined with thymopentin in thepalliative treatment of stage non-small cell lung cancer without driver gene.Methods Eighty patients with stage non-small cell lung cancer without driver gene treated in our hospital from April 2017 to November 2019 were selectedand divided into control group and observation group according to different treatment schemes,with 40 cases in each group.The control group was given thymopentin palliative treatment,while the observation group was given brucea javanica oilemulsion injection combined with thymopentin palliative treatment.The therapeutic effects of the two groups werecompared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P0.05).After treatment,the peak expiratory flow(PEF),forced vital capacity(FVC)and forced expiratory volume in onesecond(FEV1)in the observation group were higher than those in the control group(P0.05).After treatment,the cluster ofdifferentiation 3 positive(CD3+)and cluster of differentiation 4 positive(CD4+)in the observation group were higher thanthose in the control group,the cluster of differentiation 8 positive(CD8+)was lower than that in the control group,and theCD4+/CD8+was higher than that in the control group(P0.05).After treatment,the levels of interleukin-6(IL-6),tumornecrosis factor-(TNF-)in the observation group were lower than those in the control group,and the level ofinterleukin-10(IL-10)was higher than that in the control group(P0.05).After treatment,the levels of carcinoembryonicantigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 19-9(CA19-9)in the observation group werelower than those in the control group,and the score of Karnofsky Performance Status(KPS)was higher than that in thecontrol group(P0.05).The survival time of the observation group was longer than that of the control group(P0.05).Conclusion Brucea javanica oil emulsion injection combined with thymopentin in the palliative treatment of stage non-small cell lung cancer without driver gene has a good effect,which can improve the lung function and immune function ofpatients,regulate the levels of inflammatory factors and tumor markers,and improve the quality of life.KEYWORDS:brucea javanica oil emulsion injection;thymopentin;palliative treatment;stage non-small cell lungcancer;driver gene鸦胆子油乳注射液联合胸腺五肽姑息治疗期无驱动基因非小细胞肺癌的效果朱杰（泰州市中西医结合医院肿瘤科，江苏 泰州，225300）摘要：目的 分析鸦胆子油乳注射液联合胸腺五肽姑息治疗期无驱动基因非小细胞肺癌的效果。方法 选取本院 2017年 4 月至 2019 年 11 月收治的 80 例期无驱动基因非小细胞肺癌患者，按照不同的治疗方案将其分为对照组与观察组，各 40 例。对照组采取胸腺五肽姑息治疗，观察组采取鸦胆子油乳注射液联合胸腺五肽姑息治疗。比较两组的治疗效果。结果 观察组的治疗总有效率高于对照组（P0.05）。治疗后，观察组的最大呼气流量（PEF）、用力肺活量（FVC）及第 1 秒用力呼气容积（FEV1）高于对照组（P0.05）。治疗后，观察组的白细胞分化抗原 3 阳性（CD3+）、白细胞分化抗原4 阳性（CD4+）高于对照组，白细胞分化抗原 8 阳性（CD8+）低于对照组，CD4+/CD8+高于对照组（P0.05）。治疗后，观察组的白细胞介素-6（IL-6）、肿瘤坏死因子-（TNF-）水平低于对照组，白细胞介素-10（IL-10）水平高于对照组（P0.05）。治疗后，观察组的癌胚抗原（CEA）、糖类抗原 125（CA125）、糖类抗原 19-9（CA19-9）水平低于对照组，卡氏功能状态量表（KPS）评分高于对照组（P0.05）。观察组的生存时间长于对照组（P4 周；部分缓解为病灶直径之和较基线水平减少 30%以上，且 4 周内病灶大小未发生改变；稳定为病灶直径之和较基线水平减少不足 30%；进展为病灶直径之和较基线水平增大 20%以上，或发现新病灶4，8。治疗总有效率=（完全缓解例数+部分缓解例数+稳定例数）/总例数100%。（2）肺功能指标。治疗前、后采用肺功能仪（厂家：德国康讯公司；型号：PowerCube），参考美国胸科学会/欧洲呼吸学会推荐指南进行操作，测定最大呼气流量（peak expiratory flow,PEF）、用力肺活量（forced vital capacity,FVC）、第 1 秒用力呼气容量（forced expiratory volume in one second,FEV1）。（3）免疫功能指标。治疗前、后采集患者晨起空腹静脉血 35 mL，分离血清，采用全自动流式细胞仪（厂家：Beckman Coulter 公司；型号：annexinV-PI）检测白细胞分化抗原 3 阳性（cluster of differentiation 3 positive,CD3+）、白细胞分化抗原 4 阳性（cluster of differentiation 4 positive,CD4+）、白细胞分化抗原 8 阳性（cluster of differentiation 8 positive,CD8+），计算 CD4+/CD8+。（4）炎症因子水平。治疗前、后采集患者晨起空腹静脉血 35 mL，3 000 r/min 离心 20 min，分离血清，运用酶联免疫吸附法检测白细胞介素-6（interleutin-6,IL-6）、白细胞介素-10（interleutin-10,IL-10）、肿瘤坏死因子-（tumornecrosis factor-,TNF-）水平。（5）肿瘤标志物水平。治疗前、后采集患者晨起空腹静脉血 35 mL，3 000 r/min 离心 20 min，分离血清，采用全自动电化学发光免疫分析仪（厂家：瑞士罗氏公司；型号：Roche E170），运用电化学发光免疫分析法检测癌胚抗原（carcinoembryonic antigen,CEA）、糖类抗原 125（carbohydrateantigen 125,CA125）、糖类抗原 19-9（carbohydrate antigen19-9,CA19-9）水平。（6）生活质量及生存时间。治疗前、后采用卡氏功能状态量表（Karnofsky Performance Status,KPS）评估患者的生活质量，内容包括体力、症状、生活自理能力，总分 100 分，评分越高提示生活质量越好。对两组患者进行随访，记录其生存时间。1.5 统计学方法采用 SPSS21.0 统计学软件处理数据，计数资料用 n/%表示，行 2检验，计量资料用x?s 表示，行 t 检验，以 P0.05为差异具有统计学意义。2结果2.1 两组患者的临床疗效比较观察组的治疗总有效率高于对照组（P0.05，表 1）。2.2 两组患者治疗前、后的肺功能指标比较治疗后，两组的 PEF、FVC 及 FEV1均较治疗前升高，50-临床医学研究与实践2023 年 3 月第 8 卷第 7 期表 3两组患者治疗前、后的免疫功能指标比较（n=40，x?s）组别CD3+（%）CD4+（%）CD8+（%）CD4+/CD8+治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后对照组50.615.5351.236.1633.034.7834.334.9629.964.2229.354.961.190.411.230.47观察组50.575.4855.546.89*32.904.8036.605.29*30.024.1627.164.32*1.140.371.460.55*t/P0.033/0.4872.949/0.0020.121/0.4521.980/0.0260.064/0.4752.106/0.0190.573/0.2842.011/0.024注：与同组