厄多司坦对放射性肺损伤干预作用的研究

Anti-radiation effect of Erdosteine on injuries of lungs in patients with lung radiotherapy

目的观察厄多司坦对胸部肿瘤患者放射治疗的肺保护作用及对肿瘤坏死因子-α（TNF—α）表达水平的影响。方法 将胸部肿瘤放射治疗者60例随机分为治疗组和对照组。治疗组在放射治疗开始起，服用厄多司坦0．6g，2次，d，连续3个月。放射治疗前后测定血浆TNF-α，放射治疗开始15d起观察临床症状、高分辨率CT和肺功能。结果治疗组放射治疗前血浆TNF-α为（1．91±0．48）ng/ml，放射治疗后为（2．38±0．78）ng/ml；对照组放射治疗前为（1．93±0．51）n∥ml，放射治疗后为（5．06±1．03）ng/ml，明显升高（P〈0．001）。放射治疗开始后5和10个月治疗组CO弥散量下降情况与对照组比较差异有统计学意义（P〈0．05）。急性放射性肺炎和肺纤维化的发生率治疗组与对照组比较差异有统计学意义（P（0．05）。结论 厄多司坦能抑制放射治疗后血浆TNF-α的过度表达，减轻放射治疗后弥散功能的恶化。可以用于放射性肺损伤的治疗和预防。

Objective To observe the anti-radiation effect of Erdosteine on radioprotection of lung and expression of plasma tumor necrosis factor a（TNF-α） in patients with lung radiotherapy. Methods Sixty lung irradiated patients were randomized into control group （30 patients）and therapy group （30 patients）. Therapy group was administered with Erdosteine 0.6 g, po, b. i. d, for 3 months. Plasma TNF-α was examined by ELISA before and after radiotherapy. Clinical symptoms, lung function, and high-resolution computed tomography of thorax were evaluated at day 15 after the beginning of radiotherapy. Results At the end of radiotherapy, the level of TNF-α in control group was much higher than that in therapy group（5.06 ±1.03 ng/ml vs 2.38 ± 0.78 ng/ml, P 〈 0.001 ）. At months 5 and 10 after radiotherapy, patients in the therapy group whose CO diffusion capacity of lung（DLCO） declined were less than those in the control group（ P 〈 0.05）. Incidence of radiatior pneumonia and lung fibrosis was statistically different between the two groups. Conclusion-s Erdosteine can inhibit overexpression of plasma TNF-a after radiotherapy, and may reduce the severity of dysfunction lung injury. Erdosteine can prevent and treat the radioactive lung injuries.