注射用胸腺五肽治疗老年胃癌患者的临床疗效及对血清基质金属蛋白酶水平的影响

Clinical trial of thymopentin for injection in elderly patients with gastric cancer chemotherapy and its influence on levels of serum matrix metalloproteinase

目的观察注射用胸腺五肽对老年胃癌患者的临床效果及对血清基质金属蛋白酶(MMP)水平的影响。方法 46例老年胃癌化疗患者,随机分为试验组与对照组,每组23例。对照组用常规化疗方案(FOLFOX4),第1天静脉滴注奥沙利铂85 mg·m^(-2),静脉滴注2 h,第1~2天,静脉滴注亚叶酸钙200 mg·m^(-2)静脉滴注2 h,静脉注射5-氟尿嘧啶400 mg·m^(-2),持续微量化疗泵滴注5-氟尿嘧啶600 mg·m^(-2),滴注22 h。2周为1个疗程,共治疗4个疗程。试验组在对照组的基础上静脉滴注胸腺五肽40 mg,溶于0.9%Na Cl或5%葡萄糖500mL,每天1次,连续治疗30 d。观察2组的血清MMP水平、缓解率、远期生存期和生存率情况,观察2组的药物不良反应发生情况。结果试验组的缓解率为78.26%(18/23例),对照组为52.17%(12/23例),差异有统计学意义(P<0.05)。试验组1年生存率为82.61%(19/23例),对照组1年生存率为52.17%(12/23例),差异有统计学意义(P<0.05)。治疗后,对照组MMP-2、MMP-9分别为(74.50±6.22),(90.30±14.01)ng·mL^(-1),试验组分别为(35.98±3.24),(51.05±7.62)ng·mL^(-1),差异有统计学意义(P<0.05)。试验组出现消化道反应2例,白细胞严重下降1例,药物不良反应发生率为13.04%(3/23例);对照组出现消化道反应5例,白细胞严重下降2例,药物不良反应发生率为30.43%(7/23例),差异无统计学意义(P>0.05)。结论胸腺五肽辅助治疗老年胃癌化疗患者的临床疗效明显,能够有效减轻化疗的药物不良反应,降低血清MMP-2、MMP-9水平。

Objective To observe the clinical effect of thymopentin for injection in elderly patients with gastric cancer and the influence of serum matrix metalloproteinases （MMP）. Methods A total of 46 elderly patients with gastric cancer were randomly divided into treatment group and control group, each group 23 cases. Control group was given conven- tional chemotherapy regimen （FOLFOX4） ：intravenous infusion on day 1 oxaliplatin 85 mg · m^ -2, intravenous infusion of 2 h, 1 to 2 d, intrave- nous leucovorin 200 mg · m^-2 intravenously 2 h, intravenous 5 - fluorou- racil 400 mg · m^-2, continuous infusion of 5 - fluorouracil chemotherapy pump trace 600 mg· m^-2, drip 22 h. Two weeks as a course of treat- ment, and treated with 4 courses. Treatment group was intravenous infu- sion thymopentin for injection 40 rag, dissolved in 0. 9% NaCI or 5% glucose 500 mL, qd on the basis of control group for 30 d. The serum levels of MMP, response rate, survival rate and adverse drug reactions in two groups were observed. Results The response rate in control group was 78. 26% （ 18/23 cases）, had significant difference with 52. 17% （12/23 cases） in treatment group （P 〈0.05）. The 1 year survival rate in treatment group was 82.61% （19/23 cases）, had significant difference with 52. 17% （12/23 cases） in control group （P〈0.05）. After treatment, the MMP-2 and MMP-9 in control group were （74.50 ± 6.22）, （90.30±14.01） ng · mL^-1, had significant difference with those in treatment group, which were （35. 98 ±3.24）, （51.05 ＋7. 62） ng · mL^-1 （P 〈0. 05）. Treatment group had 2 cases of gastrointestinal reactions, 1 case of serious decline in white blood cells, the incidence of adverse drug reactions was 13.04% （3/23 cases）. Control group had 5 cases of gastrointestinal reactions, 2 ca- ses of serious decline in white blood cells, the incidence of adverse drug reactions was 30. 43% （7/23 cases, P 〉0. 05）. Conclusion There were obviously effective of thymopentin for injection in the treatment of elderly patients with gastric cancer, can effectively reduce the adverse drug reactions, and reduce the serum levels of MMP - 2 and MMP -9.