胸腺肽联合奥沙利铂对肺癌恶性胸腔积液患者的疗效和血清炎性因子及T淋巴细胞的影响

Effects of thymosin combined with oxaliplatin on clinical efficacy,serum inflammatory factors and T lymphocyte in patients with malignant pleural effusion of lung cancer

目的:观察胸腺肽联合奥沙利铂治疗肺癌恶性胸腔积液(malignant pleural effusion,MPE)患者的临床疗效,分析患者血清C反应蛋白(CRP)、降钙素原(PCT)和T淋巴细胞亚群水平的变化。方法:将收治的90例肺癌伴MPE患者按照抽签法随机分为对照组(n=45)和观察组(n=45),两组均行胸腔置管引流手术治疗。在此基础上,对照组胸腔注射奥沙利铂治疗,观察组胸腔注射胸腺肽联合奥沙利铂治疗。对比两组临床疗效,检测所有受试者外周血CRP、PCT和T淋巴细胞亚群水平。结果:治疗后,观察组临床有效率88.89%和疾病控制率95.56%均高于对照组,比较差异有统计学意义(P<0.05)。治疗前,两组血清CRP和PCT水平无明显差异(P>0.05);治疗后,两组CRP和PCT水平较组内治疗前均显著降低(P<0.05);且观察组显著低于治疗后对照组,差异有统计学意义(P<0.05)。治疗前,两组T淋巴细胞亚群水平无明显差异(P>0.05);治疗后,两组CD4^+和CD4^+/CD8^+水平较组内治疗前均显著升高(P<0.05);且观察组显著高于治疗后对照组,差异有统计学意义(P<0.05)。两组治疗前后CD8^+水平比较,差异无统计学意义(P>0.05)。治疗后,观察组临床有效率88.89%和疾病控制率95.56%均高于对照组,比较差异有统计学意义(P<0.05)。治疗前,两组血清CRP和PCT水平无明显差异(P>0.05);治疗后,两组CRP和PCT水平较组内治疗前均显著降低(P<0.05);且观察组显著低于治疗后对照组,差异有统计学意义(P<0.05)。治疗前,两组T淋巴细胞亚群水平无明显差异(P>0.05);治疗后,两组CD4^+和CD4^+/CD8^+水平较组内治疗前均显著升高(P<0.05);且观察组显著高于治疗后对照组,差异有统计学意义(P<0.05)。两组治疗前后CD8^+水平比较,差异无统计学意义(P>0.05)。结论:胸腺肽联合奥沙利铂治疗肺癌伴MPE患者的临床疗效显著,能更有效降低患者全身炎症反应,提高T淋巴细胞亚群水平,促进机体免疫功能的恢复,是临床潜在的有效方案。

Objective:To observe the clinical efficacy of thymosin combined with oxaliplatin in the treatment of patients with malignant pleural effusion(MPE)of lung cancer.The changes of serum C-reactive protein(CRP),procalcitonin(PCT)and T lymphocyte subsets were analyzed Methods:90 patients with lung cancer and MPE were randomly divided into control group(n=45)and observation group(n=45).Both groups were treated with thoracic catheter drainage.On the basis of this,the control group was treated with oxaliplatin in the thoracic cavity,and the observation group was given oxaliplatin combined with thymosin.The levels of CRP,PCT and T lymphocyte subsets were measured in all subjects.Results:After treatment,the clinical effective rate was 88.89%and the disease control rate was 95.56%,which were higher than those of the control group.The differences were statistically significant(P<0.05).There was no significant difference in serum CRP and PCT level between the two groups before treatment(P>0.05).After treatment,the levels of CRP and PCT in the two groups were significantly lower than those before treatment(P<0.05).And the observation group was significantly lower than those in the control group,the difference was statistically significant(P<0.05).There was no significant difference in T lymphocyte subsets between the two groups before treatment(P>0.05).After treatment,the levels of CD4+and CD4+/CD8+in the two groups were significantly higher than those before the treatment(P<0.05).The observation group was significantly higher than those in the control group after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in CD8+level between the two groups before and after treatment(P>0.05).Conclusions:Thymosin combined with oxaliplatin has a significant clinical effect in the treatment of malignant pleural effusion of lung cancer.It can effectively reduce the systemic inflammatory response,improve the level of T lymphocyte subsets and promote the recovery of immune function.It is a potentially effective clinical solution.