参麦注射液对乳腺癌术后患者的血清PCT IL-6 TNF-α水平及心肌功能的影响

Effect of Shenmai Injection on Serum PCT IL-6 TNF-alpha and Myocardial Function in Patients with Breast Cancer after Operation

目的:研究参麦注射液对乳腺癌术后患者的血清PCT、IL-6、TNF-α水平及心肌功能的影响,并评价其改善预后的效果。方法:收集2014年3月至2016年12月90例乳腺癌患者。按抽签法分为实验组和对照组,每组45例。两组患者在术后均进行化疗治疗,静脉滴注环磷酰胺、氟尿嘧啶、表柔比星。实验组在此基础上,采用参麦注射液治疗,每次50m L,加入5%葡萄糖注射液500m L中进行静脉滴注,每天1次。观察两组治疗疗效,临床症状积分,降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,肌钙蛋白(c Tn I)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)水平,超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)水平。结果:实验组总缓解率显著高于对照组[86.66%(39/45)vs66.66%(30/45)](P<0.05);乏力、自汗、口咽干燥、神疲积分均显著低于对照组[(1.53±0.23)分vs(3.10±0.63)分,(1.40±0.32)分vs(3.15±0.80)分,(1.30±0.31)分vs(3.04±0.70)分,(1.52±0.27)分vs(3.02±0.60)分](P<0.05);PCT、IL-6、TNF-α水平显著低于对照组[(1.62±0.32)μg/L vs(5.83±1.05)μg/L,(5.72±0.98)pg/m L vs(10.89±1.52)pg/m L,(1.23±0.15)ng/m L vs(2.79±0.23)ng/m L](P<0.05);c Tn I、CK、CK-MB水平显著低于对照组[(450.76±58.83)ng/L vs(702.17±83.18)ng/L,(1.87±0.40)IU/m L vs(5.20±1.34)IU/m L,(158.90±42.10)IU/L vs(910.38±97.94)IU/L](P<0.05);SOD、GSH水平显著高于对照组[(109.89±13.68)μIU/L vs(78.89±10.29)μIU/L,(140.83±20.82)μg/L vs(117.49±17.89)μg/L](P<0.05),MDA水平显著低于对照组[(5.39±1.21)μmol/L vs(12.76±3.81)μmol/L](P<0.05)。结论:参麦注射液对乳腺癌患者术后心肌保护具有显著的作用,可降低炎症因子PCT、IL-6、TNF-α水平,减少术后感染发生,有利于患者的预后。

Objective:To study the effects of Shenmai injection on serum PCT,IL-6,TNF-αand myocardial function in postoperative with breast cancer and to evaluate its effect on prognosis..Methods:90 patients of mammary cancer who received therapy from March 2014 to December 2016 in our hospital were selected as research objects.According to draw method were divided into the experimental group and the control group.Two groups of patients were treated with chemotherapy after operation,Intravenous infusion of cyclophosphamide,fluorouracil,epirubicin.The experimental group on this basis,was treated with Shenmai Injection,each 50ml,add 5%Glucose Injection 500ml to the intravenous drip,1 times a day.Then the curative effect,clinical symptom score,procalcitonin(PCT)and interleukin-6(IL-6),tumor necrosis factor alpha(TNF-alpha)levels of troponin(cTnI),creatine kinase(CK),creatine kinase(CK-MB)level,superoxide dismutase(SOD),glutathione(GSH),malondialdehyde(MDA)level of two groups were compared.Results:The total remission rate of the experimental group was significantly higher than the control group[86.66%(39/45)vs66.66%(30/45](P<0.05);Fatigue,sweating,dry mouth and throat,spiritlessness scores were significantly lower than the control group[(1.53±0.23)scores vs(3.10±0.63)scores,(1.40±0.32)scores vs(3.15±0.80)scores,(1.30±0.31)scores vs(3.04±0.70)scores,(1.52±0.27)scores vs(3.02±0.60)scores](P<0.05);PCT、IL-6、TNF-αlevel were significantly lower than the control group[(1.62±0.32)μg/L vs(5.83±1.05)μg/L,(5.72±0.98)pg/mL vs(10.89±1.52)pg/mL,(1.23±0.15)ng/mL vs(2.79±0.23)ng/mL](P<0.05);cTnI、CK、CK-MB level were significantly lower than the control group[(450.76±58.83)ng/L vs(702.17±83.18)ng/L,(1.87±0.40)IU/mL vs(5.20±1.34)IU/mL,(158.90±42.10)IU/L vs(910.38±97.94)IU/L](P<0.05);SOD,GSH level were significantly higher than the control group[(109.89±13.68)μIU/L vs(78.89±10.29)μIU/L,(140.83±20.82)μg/L vs(117.49±17.89)μg/L](P<0.05),MDA level were significantly lower than the control group[(5.39±1.21)μmol/L vs(12.76±3.81)μmoL/L](P<0.05).Conclusion:Shenmai injection has remarkable effect on myocardial protection after operation for breast cancer patients.It can reduce the levels of inflammatory factors PCT,IL-6 and TNF-alpha,reduce the incidence of postoperative infection and benefit the prognosis of patients.