小牛血清去蛋白提取物对急性放射性黏膜损伤防治的临床研究

Clinical Study on the Effect of Protein-free Hemodialysate in The Prevention and Treatment of Radiation-induced Acute Mucositis

目的探讨小牛血清去蛋白提取物对急性放射性黏膜(口咽黏膜)损伤的防治作用,寻找能够有效防治各种急性放射性黏膜损伤的理想药物。方法将鼻咽癌初治患者120例随机分成两组,每组60人,一组为试验组(放疗+局部应用生理盐水联合小牛血清去蛋白提取物雾化吸入),另一组为对照组(放疗+局部应用生理盐水联合地塞米松、庆大霉素以及维生素B12雾化吸入),观察小牛血清去蛋白提取物对于急性放射性黏膜炎(口咽黏膜)的防治作用及相关指标在治疗前后的变化。结果在疗程内随着时间的推移不断升高,治疗组的C反应蛋白(CRP)和肿瘤坏死因子-α(TNF-α)增长速度慢于对照组;放疗结束后,试验组以1级急性黏膜反应为主,而对照组的3级反应发生率要高于试验组,差异具有统计学意义(P<0.05);结论小牛血清去蛋白提取物小牛血清去蛋白提取物可有效调节CRP和TNF-α水平,减轻放疗所致的口腔黏膜免疫损伤。

Objective To investigate the prevention and treatment of radiation - induced acute mucositis by protein - free hemodia- lysate. Methods One hundred and twenty patients with radically operated nasopharyngeal carcinoma （NPC） were divided into treatment group （ n = 60） and control group （n = 60） randomly. Patients in the treatment group received physiologic saline local application com- bined with protein - free hemodialysate atomization inspiration. While patients in control group received physiologic saline local application combined with dexameth, cidomtcin, and vitamin B12 atomization inspiration. Symptoms related to radiation mucositis and serum indexs were evaluated before and after the treatments. Results Serum C - reactive protein and TNF - α were increased with the treatment process. But serum C - reactive protein and TNF - α increased more slowly in treatment group than in control group. After the radical operation, acute mucositis in treatment group exhibited primarily as grade I , and the incidence of grade BI in control groups was higher than that in treatment group （P 〈 0. 05）. Conclusion Protein - free hemodialysate may be effective in preventing radiation - induced a- cute mucositis, mucositis - related symptoms, and decreasing serum C - reactive protein and TNF - α. And its use may lead to a delayed mucositis and short duration of mucosae injury.