不同化疗方案对晚期非小细胞肺癌患者骨髓抑制及免疫力的影响

Effect on bone marrow suppression and immune function of different chemotherapy regimens for advanced non small cell lung cancer patients

目的:探讨不同化疗方案对晚期非小细胞肺癌患者骨髓抑制及免疫力的影响。方法:选择晚期非小细胞肺癌患者46例,随机分为NP组(长春瑞滨+顺铂,n=23)和DP组(多西紫杉醇+顺铂,n=23),分别于化疗前和2个周期化疗结束后监测骨髓抑制及免疫力。结果:NP组和DP组的中位生存期(MST)分别为(10.3±1.2)个月和(6.2±1.3)个月,1年生存率分别为56.52%和30.43%(P=0.00005)。两组化疗后中性粒细胞数、网织红细胞(HFR+MFR)的比率,血小板计数较化疗前呈降低趋势,与DP组相比较NP组降低幅度明显减小(均P<0.05)。NP组患者化疗后CD3、CD4、CD8、CD4/CD8及NK各数值较化疗前均明显降低(均P<0.05),与DP组相比较,CD4、CD4/CD8明显升高(均P<0.05),CD3、NK无显著性差异(均P>0.05)。结论:NP方案化疗能够减轻晚期非小细胞肺癌患者因化疗造成的免疫功能降低程度,对化疗造成的免疫功能降低程度优于DP化疗方案。

Objective ： To investigate the bone marrow inhibition and immunity effect of different chemotherapy reg- imens for advanced non small cell lung cancer patients. Methods： All 46 patients with advanced non - small cell lung cancer were randomly divided into group NP （changchun vinorelbine plus cisplatin, n = 23 ）and group DP （docetaxel, cisplatin, n = 23 ）. Before chemotherapy and after 2 cycles of chemotherapy, bone marrow suppression and immune function were analyzed. Results： In NP group and DP group, the median survival time （MST） were 10. 3± 1.2 and 6.2 ± 1.3 months,1 year survival rates were 56.52% and 30.43% （P = 0.00005 ）. The two group of chemo- therapy neutrophil count, reticulocyte （HFR ＋ MFR） ratio, platelet count decreased than before chemotherapy, and group DP compared with NP group decreased significantly （ P 〈 0.05 ）. After chemotherapy patients in group NP CD3, CD4, CDS, CD4/CD8 and NK before chemotherapy were decreased significantly （ P 〈 0.05 ） , and in DP group, CD4,CD4/CD8 elevated （P 〈 0.05 ）, CD3, NK have didn＇t change （ P 〉 0.05 ）. Conclusion： NP can reduce the chemotherapy influence in advanced non - small cell lung cancer patients on the immune function resulting in immune function better than that DP regimen.