甘露聚糖肽联合人参皂苷对浅表性膀胱癌患者细胞免疫功能及血管内皮生长因子的影响

Effects of mannatide combined with ginsenoside on cellular immune function and vascular endothelial growth factor in patients with superficial bladder cancer

目的探讨甘露聚糖肽联合人参皂苷Rg3对浅表性膀胱癌患者细胞免疫功能及血管内皮生长因子(vascular endothelial growth factor,VEGF)的影响。方法选择我院于2015年1月~2018年1月期间收治的108例浅表性膀胱癌患者作为研究对象,采用随机数表法将所有患者分为观察组与对照组,每组54例。两组均进行经尿道膀胱肿瘤切除术(TURBT),术后对照组采用甘露聚糖肽进行膀胱灌注,观察组采用甘露聚糖肽联合人参皂苷Rg3进行干预。比较两组患者复发情况、功能状态评分、不良反应、免疫指标自[然杀伤细胞(NK)水平与外周血T淋巴细胞亚群(CD3+、CD4+、CD8+)]及VEGF水平变化情况。结果治疗后1年内观察组总复发率为9.26%,显著低于对照组的24.07%,差异有统计学意义(P<0.05)。治疗后与对照组相比,观察组CD3+、CD4+、CD4+/CD8+、NK水平均显著升高,而CD8+水平降低,差异有统计学意义(P<0.05)。治疗后观察组不同时间段的KPS评分均显著高于对照组,差异有统计学意义(P<0.05)。治疗后两组血清VEGF水平均不断下降,且治疗后观察组各个时间段的血清VEGF水平均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为11.11%,与对照组的9.26%相比,差异无统计学意义(P>0.05)。结论采用甘露聚糖肽灌注联合人参皂苷Rg3口服能明显减少浅表性膀胱癌TURBT术后的复发情况,改善患者细胞免疫功能与VEGF水平,且联合用药不良反应少,安全性较高,同时能够提高患者的生存率与生存质量。

Objective To investigate the effects of mannatide combined with ginsenoside Rg3 on cellular immune function and vascular endothelial growth factor(VEGF) in patients with superficial bladder cancer. Methods A total of 108 patients with superficial bladder cancer who were admitted in our hospital from January 2015 to January 2018 were enrolled. All patients were divided into observation group and control group by random number table, with 54 cases in each group. Transurethral resection of the bladder (TURBT) was performed in both groups. The control group was treated with mannatide for bladder perfusion after surgery. The observation group was treated with mannatide and ginsenoside Rg3. The recurrence, functional status score, adverse reactions, immune indexes [natural killer (NK) levels and peripheral blood T lymphocyte subsets (CD3+, CD4+, CD8+)] and VEGF levels were compared between the two groups. Results The total recurrence rate of the observation group was 9.26% within 1 year after treatment, which was significantly lower than that of the control group(24.07%). The difference was statistically significant (P<0.05). Compared with the control group after treatment, the levels of CD3+, CD4+, CD4+/CD8+, and NK in the observation group were significantly increased, while the levels of CD8+ were decreased in the observation group, and the difference was significant (P<0.05). The KPS scores of the observation group were significantly higher than those of the control group after treatment, and the difference was statistically significant(P<0.05). After treatment, serum VEGF levels in both groups decreased continuously, and serum VEGF levels in the observation group were lower than those in the control group in the various time periods after treatment. The difference was significant (P<0.05). There was no statistically significant difference between the incidence of adverse reactions in the observation group (11.11%) and that in the control group (9.26%)(P>0.05). Conclusion The combination of mannatide infusion and ginsenoside Rg3 can significantly reduce the recurrence of superficial bladder cancer after TURBT, improve the cellular immune function and VEGF level, which has fewer adverse reactions and higher safety, and can improve patient survival rate and quality of life.