摘要
目的探讨高压氧综合治疗对非小细胞肺癌患者放射性肺损伤的疗效及其作用机制。方法选取2020年7月至2022年2月临沂市中心医院胸外科收治的拟手术后放疗的非小细胞肺癌患者106例作为研究对象。按照随机数字表法分为对照组和研究组,每组53例。对照组患者采用单纯放射治疗,研究组在此基础上给予高压氧治疗。治疗6周后评估2组患者的临床效果、骨髓抑制及肺损伤发生情况。采用酶联免疫吸附法检测患者血清转化生长因子(TGF-β1)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β和肺泡表面活性蛋白A(SP-A)水平。采用流式细胞仪测定患者外周静脉血T淋巴细胞CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+)值。结果研究组治疗后临床治疗总有效率(73.58%)显著高于对照组(50.94%),差异有统计学意义(χ^(2)=4.527,P=0.033)。研究组治疗后早期肺损伤发生率、晚期肺损伤发生率及骨髓抑制发生率均明显低于对照组(P<0.001)。2组患者治疗后血清TGF-β1、TNF-α、IL-1β和SP-A水平均明显低于治疗前,且研究组治疗后上述指标明显低于对照组(P<0.01或P<0.001)。研究组患者治疗后外周血CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)值明显高于对照组,CD8^(+)明显低于对照组(P<0.01或P<0.001)。结论高压氧综合治疗可以明显降低非小细胞肺癌患者的放射性肺损伤,降低炎症因子的表达水平,提高机体免疫功能,具有较好的临床应用价值。
Objective To investigate the therapeutic effect and mechanism of hyperbaric oxygen therapy(HBOT)on radiation-induced lung injury in patients with non-small cell lung cancer.Methods A total of 106 patients with non-small cell lung cancer admitted to the department of thoracic surgery of Linyi central hospital from July 2020 to February 2022 were selected as the study subjects.They were divided into control group and study group according to the random number table method,with 53 cases in each group.The patients in the control group were treated with radiotherapy alone,while the patients in the study group were given HBOT on the basis of the treatment of the control group.After six weeks of treatment,the clinical effect,bone marrow suppression,and lung injury of the two groups were evaluated.Enzyme-linked immunosorbent assay was used to detect the levels of transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and surfactant protein A(SP-A)in patients’serum.Flow cytometry was used to measure the values of T lymphocyte subsets,i.e.,CD3+,CD4+,and CD8+,as well as the CD4+/CD8+ratio,in peripheral venous blood of the patients.Result The total effective rate in the study group(73.58%)was significantly higher than that in the control group(50.94%),and the difference was statistically significant(χ^(2)=4.527,P=0.033).The incidences of early lung injury,late lung injury,and bone marrow suppression in the study group after treatment were significantly lower than those in the control group(P<0.001).In both groups of patients,the levels of serum TGF-β,TNF-α,IL-1β,and SP-A after treatment were significantly lower than those before treatment,and the above indicators in the study group were significantly lower than those in the control group(P<0.01 or P<0.001).After treatment,the values of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)ratio in the peripheral blood of the study group were significantly higher than those of the control group,while the CD8^(+)value was significantly lower than that of the control group(P<0.01 or P<0.001).Conclusion HBOT can significantly reduce the radiation-induced lung injury in patients with non-small cell lung cancer by lowering the expression levels of inflammatory factors and thus improving immune function,which demonstrates good clinical value for the treatment of patients with radiation-induced lung injury.
作者
程子明
武玉兵
王云龙
杨旭东
Cheng Ziming;Wu Yubing;Wang Yunlong;Yang Xudong(Department of Thoracic Surgery,Linyi Central Hospital,Linyi 276400,China;Department of Radiotherapy,Linyi Central Hospital,Linyi 276400,China;Department of Thoracic Surgery,The First Affiliated Hospital of Shandong First Medical University,Jinan 250014,China)
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2023年第5期577-581,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
关键词
高压氧
非小细胞肺癌
放射性肺损伤
Hyperbaric oxygen
Non-small cell lung cancer
Radiation-induced lung injury
