脾多肽注射液联合mFOLFOX6方案治疗晚期结肠癌的效果及对免疫功能的影响

Effect of Lienal Polypeptide Injection combined with mFOLFOX6 chemotherapy in treatment of advanced colon cancer and influence on immune function

目的探讨脾多肽注射液联合m FOLFOX6方案治疗晚期结肠癌的效果,以及了解其对患者免疫功能的影响。方法选择2013年1月~2016年12月中南大学湘雅医学院附属海口医院肿瘤化疗科收治的晚期结肠癌患者80例,按随机数字表法分为观察组和对照组,每组各40例。两组患者均给予m FOLFOX6方案化疗4个周期,观察组化疗同时加用脾多肽注射液。化疗结束后比较两组患者外周血T淋巴细胞亚群水平、近期疗效、毒副反应发生率及卡氏评分得分情况。结果化疗后,观察组CD_3^+、CD_4^+T细胞数值及CD_4^+/CD_8^+比值较化疗前均增高,差异有统计学意义(P<0.05),CD_8^+T细胞数值较化疗前下降,差异有统计学意义(P<0.05);化疗后,对照组患者CD_3^+、CD_4^+T细胞数值及CD_4^+/CD_8^+比值较化疗前均降低,差异有统计学意义(P<0.05),CD_8^+T细胞数值较化疗前升高,差异有统计学意义(P<0.05);化疗后,观察组患者CD_3^+、CD_4^+T细胞数值及CD_4^+/CD_8^+T细胞比值较对照组均升高,差异有统计学意义(P<0.05),CD_8^+T细胞数值则降低,差异有统计学意义(P<0.05)。观察组患者总有效率和疾病控制率均略高于对照组,但差异无统计学意义(P>0.05)。观察组患者化疗后Ⅲ+Ⅳ度贫血、白细胞减少的发生率均低于对照组,差异有统计学意义(P<0.05),而两组恶心呕吐、血小板减少、外周感觉神经毒性、腹泻及肝肾功能损害发生率的比较,差异无统计学意义(P>0.05)。观察组患者化疗后的卡氏评分和生活质量改善率高于对照组,差异有统计学意义(P<0.05)。结论在晚期结肠癌患者化疗过程中辅以脾多肽注射液能提高患者近期T淋巴细胞亚群免疫功能并促进其恢复,同时,在一定程度上减轻化疗造成的血液毒性,改善化疗后患者的生活质量。

Objective To invesLigaLe Lhe clinical efficacy of Lienal PolypepLide InjecLion combined wiLh mFOLFOX6 chemoLherapy on advanced colon cancer chemoLherapy and observe iLs effecL on Lhe immune funcLion.Methods From January 2013 Lo December 2016,in DeparLmenL of Oncology,CenLral SouLh UniversiLy Xiangya School of Medicine Af-filiaLed Haikou HospiLal,80 advanced colon cancer paLienLs were selecLed,according Lo random number Lable meLhod,Lhey were divided inLo observaLion group and conLrol group,wiLh 40 cases in each group.PaLienLs of Lwo groups were given mFOLFOX6 regimen for 4 cycles,and Lhe observaLion group was given Lienal PolypepLide InjecLion combined wiLh chemoLherapy.AfLer chemoLherapy,Lhe peripheral blood T lymphocyLe subseLs,Lhe recenL curaLive effecL,Lhe side effecLs of chemoLherapy and KPS score in Lhe Lwo groups were compared.Results AfLer chemoLherapy,Lhe number of CD3+,CD4+T lymphocyLes and Lhe raLio of CD4+/CD8+in Lhe observaLion group increased,Lhe differences were sLaLisLically significanL(P<0.05),Lhe number of CD8+T lymphocyLes decreased,Lhe difference was sLaLisLically significanL(P<0.05);afLer chemoLherapy,Lhe number of CD3+,CD4+T lymphocyLes and Lhe raLio of CD4+/CD8+in conLrol group de-creased,Lhe differences were sLaLisLically significanL(P<0.05),Lhe number of CD8+T lymphocyLes increased,Lhe dif-ference was sLaLisLically significanL(P<0.05);afLer chemoLherapy,Lhe number of CD3+,CD4+T cells and Lhe raLio of CD4+/CD8+T cells in Lhe observaLion group were higher Lhan Lhose in Lhe conLrol group,Lhe differences were sLaLisLically significanL(P<0.05),Lhe number of CD8+T cells was lower,Lhe difference was sLaLisLically significanL(P<0.05).The recenL curaLive effecL,LoLal effecLive raLe and disease conLrol raLe in Lhe observaLion group were slighLly higher Lhan Lhose in Lhe conLrol group,buL Lhe differences were not sLaLisLicany significanL(P>0.05).The incidence raLes ofⅢ+Ⅳdegree anemia,leukopeniawere in Lhe observaLion group afLer chemoLherapy were lower Lhan Lhose in Lhe conLrol group,Lhe differences were sLaLisLically significanL(P<0.05),and Lhe incidence raLes of peripheral sensory neuropaLhy,nausea and vomiLing,LhrombocyLopenia,diarrhea,liver funcLion damage and renal funcLion damage in Lhe Lwo groups were com-pared,Lhe differences were noL sLaLisLically significanL(P>0.05).Compared wiLh Lhe conLrol group,Lhe KPS score and qualiLy of life improvemenL of Lhe observaLion group were higher afLer chemoLherapy,Lhe differences were sLaLisLically significanL(P<0.05).Conclusion Lienal PolypepLide InjecLion can effecLively correcL Lhe disLurbance of immune func-Lion in paLienLs wiLh advanced colon cancer during chemoLherapy,alleviaLe Lhe blood LoxiciLy caused by chemoLherapy and improve Lhe qualiLy of life of paLienLs.