克拉霉素治疗鼻咽癌放疗后鼻窦的损伤及血浆miR-24表达的影响

Effect of Clarithromycin in Treatment of Sinus Damage and Expression of miR-24 in Gasopharyngeal Carcinoma After Radiotherapy

目的探讨克拉霉素对鼻咽癌放疗后鼻窦损伤治疗及血浆miR-24基因表达的作用。方法选自2014年12月至2016年6月我院行鼻咽癌放疗后出现鼻窦损伤的82例患者,随机分为对照组和观察组,观察组给予克拉霉素片(250mg/次,1日/次),对照组给予阿奇霉素片治疗,250mg/次,1日/次,治疗15天,观察鼻窦的损伤修复情况及对miR-24基因表达的影响。结果观察组的临床总有效率92.68%明显高于对照组85.37%(P<0.05);观察组的鼻部症状改善差异具有统计学意义(P<0.05),观察组的VAS及鼻窦CT影像的Lund-Mackay评分改善治疗效果显著优于对照组;观察组的血浆miR-24基因表达相对于对照组显著受到抑制。讨论克拉霉素治疗鼻咽癌放疗后引起的鼻窦损伤,且能够通过抑制miR-24基因表达,提高患者5年的生存率。

Objective To investigate the effect of clarithromycin on the treatment of nasal sinus injury and the expression of miR-24 in nasopharyngeal carcinoma after radiotherapy. Methods From December 2014 to June 2016, 82 patients with nasal sinus injury after nasopharyngeal carcinoma radiotherapy were randomly divided into two groups： the control group and the observation group. The observation group was given clarithromycin tablets（250mg qd）, the control group was treated with azithromycin tablets, qd, for 15 days to observe the repair of injury and miR-24 expression. Results The total effective rate was 92.68% in the observation group, which was significantly higher than that in the control group 85.37% （ P 〈 0.05 ）. The nasal symptoms of the observation group （nasal congestion, nasal congestion and turbinate, nasal secretions, olfactory deterioration and headache） improved（P 〈 0.05 ）. The VAS score and Lund-Mackay score of CT images in the observation group was significantly better than that of the control group. The expression of miR-24 in the observation group was significantly inhibited compared with the control group. Conclusion Clarithromycin treatment on sinus injury after nasopharyngeal carcinoma radiotherapy might be related to inhibition of miR-24 expression and improve patients 5-year survival.