痰热清注射液对基质金属蛋白酶9的影响及防治放射性肺损伤的疗效观察

EFFECT OF TANREQING INJECTION ON PREVENTION OF RADIATION-INDUCED PULMONARY INJURE AND MATRIX METALLOPROTEINASE-9

目的观察痰热清注射液防治放射性肺损伤的临床疗效及对基质金属蛋白酶9(MMP-9)的影响。方法将90例需要进行放射治疗的肺癌患者随机分为二组,观察组42例放射治疗同时予痰热清注射液静滴;对照组48例只予常规放射治疗。于放射治疗开始后1h、24h和72h、1周(潜伏期)、2周、4周、8周、16周(肺炎期)、24周(肺纤维化期)抽空腹静脉血,用酶联免疫吸附法(ELISA法)测定血清MMP-9的含量。结果急性放射性肺炎总发生率观察组为23.81%,对照组为35.42%;3、4级肺炎发生率观察组7.14%,对照组35.71%;3、4级肺炎平均发病剂量分别为60Gy和55Gy;放射性肺炎平均发病时间分别为42d和30d;肺纤维化发生率观察组为26.19%,对照组为56.25%。观察组血清MMP-9的含量较对照组高,且下降趋势缓慢。结论痰热清注射液能改变血清MMP-9的表达,有效预防和推迟严重性急性放射性肺炎及肺纤维化的发生;对减轻放射性肺损伤、提高生存质量、保证放射治疗的顺利进行具有积极意义。

Objective To observe the clinical therapeutic effect of Tanreqing Injection on prevention of radiation- induced pulmonary injure and changes of matrix metalloproteinase - 9 （MMP - 9） levels in plasma. Methods 90 cases were randomly divided into two groups： 42 cases in the observation group, who were treated by intravenous drip of Tanreqing Injection combined with radiotherapy; the other 48 cases in the control group, who were treated with conventional radiotherapy. Blood specimens were taken from veins at 1 h, 24 h, 72 h, lth week, 2th week, 4th week, 8th week, 16th week and 24th week after radiotherapy to determine the levels of MMP - 9 in plasma with ELISA. Results The total rates of acute radiation pneumonitis, in the observation group and the control group, were 23.81 % and 35. 42% respectively. Grade 3 or 4 acute radiation pneumonitis occurred in 7. 14% of patients treated with Tanreqing Injection,and 35. 71% in the control group. The mean doses of radiation were 60 Gy and 55 Gy respectively. The average courses to occur acute radiation pneumonitis were 42 days and 30 days respectively. The rates of radiation pulmonary fi- brosis in the observation group and the control group were 26.19% and 56. 25% respectively. Moreover, the plasma levels of MMP - 9 were obviously higher in observation group than that in control group. Conclusion MMP- 9 expression is up- regulated by Tanreqing Injection. Tanreqing Injection is effective in preventing the occurrence of Grade 3 or 4 acute radiation pneumonitis and radiation pulmonary fibrosis. It is proved that Tanreqing Injection may elevate the life quality and ensure successful radiotherapy.