化疗联合康莱特注射液用于非小细胞肺癌术后辅助治疗的临床研究

发布时间：2018-06-15 04:50

本文选题：康莱特注射液 + 非小细胞肺癌　；参考：《兰州大学》2017年硕士论文

【摘要】：目的:研究化疗联合康莱特注射液对非小细胞肺癌(Non-small cell lung cancer,NSCLC)外科术后患者的免疫力及恢复情况的影响。方法:选择2015年6月—2016年6月于本院就诊的NSCLC患者81例。首先根据病理类型的不同分为鳞癌和非鳞癌两组,每组再通过抽签随机分成两小组,即观察组和对照组,鳞癌组化疗方案为:多西他赛80 mg/m2,d1;顺铂75mg/m2,d1;非鳞癌组化疗方案为:培美曲塞500 mg/m2,d1,顺铂75 mg/m2,d1。观察组从接受化疗的第1天开始加用康莱特注射液(KLT),200 m L ivgtt d1-7。每个疗程间隔3周,连续治疗4个疗程,评价其疗效。第一次化疗前和第四次化疗后分别评估患者卡氏评分(Karnofsky,KPS),并抽取患者静脉血,送至检验科检验淋巴细胞亚群分型:总T细胞(CD3+)、总B细胞(CD3-CD19+)、T辅助细胞(Th,CD3+CD4+)、T抑制/杀伤细胞(Ts/Tc,CD3+CD8+)、CD4+/CD8+以及NK细胞(CD3-CD16+CD56+)的水平的变化,比较其差异是否具有统计学意义,探讨KLT对机体免疫状况的影响。结果:(1)在鳞癌组及非鳞癌组,化疗前经统计分析,观察组与对照组患者淋巴细胞亚群检测及KPS评分没有明显差别,统计差异均无意义,P0.05,两组具可比性。(2)在鳞癌组及非鳞癌组,与化疗前相比,对照组中患者的淋巴细胞亚群检测:CD3-CD19+、CD3+、CD4+/CD8+、CD3+CD4+以及NK细胞均降低,CD3+CD8+均升高,统计差异均有意义,P0.05。(3)在鳞癌组中,相比化疗前,观察组患者的淋巴细胞亚群检测:CD3-CD19+、CD3+、CD3+CD8+、CD3+CD4+以及NK细胞略升高,CD4+/CD8+略降低,统计差异均无意义,P0.05。(4)在非鳞癌组中,相比化疗前,观察组患者的淋巴细胞亚群检测:CD3-CD19+、CD3+、CD4+/CD8+、CD3+CD4+以及NK细胞均略升高,CD3+CD8+略降低,统计差异均无意义,P0.05。(5)在鳞癌组及非鳞癌组,化疗后,对照组中患者的淋巴细胞亚群检测:CD3-CD19+、CD3+、CD4+/CD8+、CD3+CD4+以及NK细胞均明显低于观察组,CD3+CD8+均明显高于观察组,统计差异均有意义,P0.05。(6)在鳞癌组及非鳞癌组,与化疗前相比,患者KPS评分改善的例数均明显高于对照组,统计差异均有意义,P0.05。结论:化疗可以降低NSCLC术后患者的免疫功能,并降低患者的生活质量;化疗联合康莱特注射液可以提高NSCLC术后患者的免疫功能并改善患者的生活质量。
[Abstract]:Objective: to study the effect of chemotherapy combined with Kanglaite injection on immunity and recovery of patients with non-small cell lung cancer after NSCLC surgery. Methods: 81 NSCLC patients from June 2015 to June 2016 were selected. First of all, they were divided into two groups according to different pathological types: squamous cell carcinoma and non-squamous cell carcinoma. Each group was then randomly divided into two groups by drawing lots, namely, the observation group and the control group. The chemotherapy regimen of squamous cell carcinoma group was docetaxel 80 mg / m 2 / d 1; cisplatin 75 mg / m 2 d 1; non squamous cell carcinoma group 500 mg / m 2 d 1; cisplatin 75 mg / m 2 d 1. The observation group was treated with Kanglaite injection 200ml ivgtt d1-7 from the first day of chemotherapy. Each course of treatment interval 3 weeks, continuous treatment of 4 courses of treatment, to evaluate its efficacy. Before the first chemotherapy and after the fourth chemotherapy, the patients were evaluated for Karnofsky KPSV, and their venous blood was drawn. Sent to the laboratory to examine lymphocyte subsets: total T cell CD3-CD19 / T helper T cell Tsr / Tctcc CD3 CD8 + CD8 / CD8 / NK cell CD3-CD16 CD56) were compared with each other, and whether there was statistical significance in the changes of T _ s / T _ (3) CD _ 4 / CD _ 4 / CD _ 4 / CD _ 8 / CD _ 8 / CD _ 8 / CD _ 3-CD _ (16) / CD _ (56) levels. To investigate the effect of KLT on immune status. Results before chemotherapy, there was no significant difference in lymphocyte subsets and KPS scores between the observation group and the control group, but there was no significant difference between the two groups (P 0.05). Compared with before chemotherapy, the lymphocyte subsets of the patients in the control group were detected. The percentage of CD4 / CD8 CD3 CD4 and NK cells in the control group were lower than those before chemotherapy. The statistical difference was significant (P 0.05.3) in the squamous cell carcinoma group, compared with before chemotherapy, there was a significant difference between the two groups. The lymphocyte subsets of the patients in the observation group were detected. The percentage of CD4 / CD8 CD3 CD4 and the increased CD4 / CD8 ratio of NK cells were slightly increased. The statistical differences were not significant (P 0.05.44) in the non-squamous cell carcinoma group, compared with those before chemotherapy, there was no significant difference between the two groups. The lymphocyte subsets of the patients in the observation group were detected. The CD4 / CD8 / CD8 / CD3 CD4 and NK cells increased slightly and CD3 / CD8 decreased slightly in the observation group. The statistical difference was not significant (P 0.05. 05. 5) in the squamous cell carcinoma group and non squamous cell carcinoma group, after chemotherapy, there was no significant difference between the two groups. The lymphocyte subsets in the control group were significantly lower than those in the observation group (P 0.05.6), and were significantly lower in the control group than in the control group (P 0.05.6). The number of patients with improved KPS score was significantly higher than that of the control group (P 0.05). Conclusion: chemotherapy can reduce the immune function and the quality of life of the patients after NSCLC, chemotherapy combined with Kanglaite injection can improve the immune function and the quality of life of the patients after NSCLC.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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