参麦注射液联合化疗对晚期非小细胞肺癌患者T细胞亚群及细胞因子的影响

摘要

目的：研究参麦注射液联合化疗对晚期非小细胞肺癌（NSCLC）患者的 T 细胞亚群及细胞因子表达的影响。方法将符合研究标准的48例患者随机分为联合治疗组和单纯化疗组，鳞癌患者均予多西紫杉醇联合顺铂化疗、腺癌及大细胞癌均予培美曲塞二钠联合顺铂化疗，联合治疗组在上述方案上加用参麦注射液。在化疗前及化疗2周期后检测外周 T 淋巴细胞亚群及 NK 细胞活性等免疫指标，检测外周血细胞因子水平，同时评价患者化疗近期疗效及不良反应。结果治疗后联合治疗组 CD4＋水平及 CD4＋／CD8＋明显升高（P ＜0．05～0．01），与单纯化疗组比，CD3＋、CD4＋水平及 CD4＋／CD8＋有显著性差异（P＜0．01）。联合治疗组 IFN-γ、TNF-α、IL-2、IL-6含量明显升高（P ＜0．01），与单纯化疗组比，IFN-γ、IL-2有显著性差异（P ＜0．01）。2组近期疗效无统计学差异。联合治疗组中血液学毒性发生率较单纯化疗组下降（P ＜0．05～0．01）。结论参麦注射液联合化疗能改善晚期非小细胞肺癌患者的细胞免疫功能，进一步逆转 Th1向 Th2漂移。%ABSTRACT:OBJECTIVE To observe the impact of Shenmai injection combined with chemotherapy on advanced non-small cell lung cancer patients'immunity and cytokines.METHODS 48 cases were randomly divided into two groups:the combining treatment group and the chemotherapy group.Patients with squamous carcinoma were given Docetaxel and cisplatin chemo-therapy;patients with adenocarcinomas and large cell carcinoma were given pemetrexed disodium together with cisplatin chem-otherapy.Shenmai injection was added in the combining treatment group.Immune indexes like peripheral T lymphocyte sub-sets and the viability of NK cells together with peripheral blood cell factor level and short term effects of chemotherapy and the side effects shown were recorded before the chemotherapy and two cycles of treatment.RESULTS After treatment,the level of CD4+ and CD4+/CD8+ in combined treatment group increased significantly(P <0.05~0.01).Compared to the chemother-apy group,the levels of CD3 + ,CD4+ and CD4+/CD8+ of treatment group have significant difference(P <0.01).The expres-sion of IFN-γ,TNF-α,IL-2 in combination group increased significantly(P <0.01).The levels of IFN-γand IL-2 of treatment group had significant difference(P <0.01),compared with the control group.The response rate of these two groups is similar. The incidence of hematologic toxicities in the treatment group was lower than that in control group(P <0.05~0.01).CON-CLUSION The combination of Shenmai injection with chemotherapy can improve advanced stage non-small lung cancer pa-tients'immunity and reverse the Th1/Th2 ratio,and reduce the toxicity of chemotherapy.