胸腺五肽预防晚期肺癌机会性真菌与寄生虫感染的研究

Effect of thymopentin in the prevention of the opportunistic fungal and parasitic infections during treatment of the late cases with lung cancer

目的 评价胸腺五肽在预防晚期肺癌机会性真菌与寄生虫感染中的作用。方法 将经组织学或细胞学证实的4 2例晚期非小细胞肺癌分为两组,A组(实验组) 2 3例,采用诺维本联合顺铂(即NP方案)进行治疗,同时辅助胸腺五肽1～2mg/d静滴,15天为一疗程;B组(对照组) 19例,只单独采用NP方案,连续应用2～3周期后评价疗效。结果 1.A组、B组在治疗前后,外周血白细胞的变化均有显著性差异(A组:P <0 .0 5 ,B组P <0 .0 1) ;2 .从T细胞亚群的检测来看,B组的CD4 +细胞下降明显,从疗前的4 1.91%下降到33.17% ,治疗前后比较P <0 .0 5 ,有显著性差异;从NK细胞活性的检测来看,A组的NK细胞活性由治疗前的2 1.38上升到2 8.0 7,增加了31.2 9% ,P <0 .0 5 ,有显著性差异。3.两组病人在化疗中出现肺部机会性感染的情况为:A组感染率为8.6 9% ;B组为2 6 .3% ,二组之间有显著性差异(P <0 .0 5 )。结论 胸腺五肽能减少化疗后患者的骨髓抑制现象,预防外周血白细胞、CD4 +细胞的降低,提高患者的细胞免疫功能和NK细胞的活性,对晚期非小细胞肺癌患者机会性感染的发生有一定的预防作用。

To evaluate the efficiency of thymopentin in the prevention of the fungal and parasitic infections during treatment of advanced cases of the non-small cell lung carcinoma (NSCLC), 42 patients with histologically documented NSCLC were randomized into two groups, 23 in the experimental group (A group), and 19 in the control group (B group).All the patients received navelbine plus cisplattin treatment with a cycle of treatment of 21 days. Thymopentin, dissolved in 250 ml of 0.9% sodium chloride was given to each patient in A group, 1mg each time, 1～2 times per day, and altogether, 15 days were required to complete the whole course of treatment. It was found that there were significant difference in the changes of the peripoheral blood leukocytes before and after treatment with thymopentin, in which the CD+ 4 cells in B group dropped from 41.91% before treatment to 33.17% after treatment, while the activities of NK cells in A group increased obviously from 21.38 before treatment to 28.07 after treatment with an increase of 31.29% of high significance The percentages of occurrence of the opportunistic infections in lungs of both groups in the course of the anti-cancer treatment were 8.69% in A group and 26.3% in B group respectively, indicating a significant difference between these two groups. It is concluded that thymopentin can reduce the appearance of bone marrow suppression effectively, and prevent the reduction of peripheral blood leukocytes and CD+ 4 cells induced by chemotherapy. In addition, it also enhance the cellular immune responses and the activities of NK cells, as well as reduce the occurrence of the opportunistic infections in the course of treatment with anti-cancer drugs.